Healthcare Provider Details

I. General information

NPI: 1033427448
Provider Name (Legal Business Name): CHARITY TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 INDEPENDENCE BLVD SUITE B
VIRGINIA BEACH VA
23455-4038
US

IV. Provider business mailing address

1225 RIVER OAKS DR
NORFOLK VA
23502-2041
US

V. Phone/Fax

Practice location:
  • Phone: 757-226-9916
  • Fax: 757-512-8802
Mailing address:
  • Phone: 757-226-9916
  • Fax: 757-512-8802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-171533
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number202
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number905705
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number905705
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number202
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number20276
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number202
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number905705
License Number StateVA

VIII. Authorized Official

Name: MS. TRACY LORRAINE JONES
Title or Position: SOLE MEMBER
Credential:
Phone: 757-309-3975