Healthcare Provider Details

I. General information

NPI: 1346902160
Provider Name (Legal Business Name): W & A ASSURANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 10/08/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6916 BONNOT DR
NORFOLK VA
23513-1102
US

IV. Provider business mailing address

6916 BONNOT DR
NORFOLK VA
23513-1102
US

V. Phone/Fax

Practice location:
  • Phone: 757-214-8721
  • Fax:
Mailing address:
  • Phone: 757-214-8721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: AYANA WILLIS
Title or Position: OWNER
Credential:
Phone: 757-214-8721