Healthcare Provider Details

I. General information

NPI: 1982233490
Provider Name (Legal Business Name): D19 TRANSPORTATION SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 BLUE STAR HWY
STONY CREEK VA
23882-3218
US

IV. Provider business mailing address

10004 BLUE STAR HWY
STONY CREEK VA
23882-3218
US

V. Phone/Fax

Practice location:
  • Phone: 434-632-1157
  • Fax: 866-230-2666
Mailing address:
  • Phone: 434-632-1157
  • Fax: 866-230-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: EARL A BLACKMAN
Title or Position: PRESIDENT
Credential:
Phone: 434-632-1157