Healthcare Provider Details

I. General information

NPI: 1558923805
Provider Name (Legal Business Name): A GENTLE HAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2019
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W WASHINGTON ST STE 111
SUFFOLK VA
23434-5268
US

IV. Provider business mailing address

112 W WASHINGTON ST STE 111
SUFFOLK VA
23434-5268
US

V. Phone/Fax

Practice location:
  • Phone: 757-304-6624
  • Fax: 757-304-6624
Mailing address:
  • Phone: 757-304-6624
  • Fax: 757-304-6624

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 Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. GUYRON JONES
Title or Position: PARTNER
Credential:
Phone: 757-304-6624