Healthcare Provider Details

I. General information

NPI: 1245634344
Provider Name (Legal Business Name): DUNAMIS TRANSIT SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 WESTOVER AVE
RICHMOND VA
23231-3957
US

IV. Provider business mailing address

2204 WESTOVER AVE
RICHMOND VA
23231-3957
US

V. Phone/Fax

Practice location:
  • Phone: 804-638-4009
  • Fax: 804-226-1870
Mailing address:
  • Phone: 804-638-4009
  • Fax: 804-226-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateVA

VIII. Authorized Official

Name: ELVIS FLEETWOOD BROOKS JR.
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 804-638-4009