Healthcare Provider Details

I. General information

NPI: 1295010171
Provider Name (Legal Business Name): LAYTER TRANSPORTATION COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4129 TOWNHOUSE RD APT H
RICHMOND VA
23228-5321
US

IV. Provider business mailing address

4129 TOWNHOUSE RD APT H
RICHMOND VA
23228-5321
US

V. Phone/Fax

Practice location:
  • Phone: 804-852-7432
  • Fax: 804-379-9258
Mailing address:
  • Phone: 804-852-7432
  • Fax: 804-379-9258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberL11003002
License Number StateVA

VIII. Authorized Official

Name: MS. CAROLYN HARRIS
Title or Position: OWNER
Credential:
Phone: 804-852-7432