Healthcare Provider Details

I. General information

NPI: 1295260917
Provider Name (Legal Business Name): GO 3 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 VILLAGE FIELD DR
RICHMOND VA
23231-5675
US

IV. Provider business mailing address

1455 VILLAGE FIELD DR
RICHMOND VA
23231-5675
US

V. Phone/Fax

Practice location:
  • Phone: 804-400-7444
  • Fax:
Mailing address:
  • Phone: 804-400-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateVA

VIII. Authorized Official

Name: KAREEMA CHERRY
Title or Position: OWNER/OPERATOR
Credential:
Phone: 804-400-7444