Healthcare Provider Details

I. General information

NPI: 1871457499
Provider Name (Legal Business Name): DYER TOMBLIN TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 EAST FORK TWELVEPOLE
DINGESS WV
25649-0294
US

IV. Provider business mailing address

PO BOX 294
VERDUNVILLE WV
25649-0294
US

V. Phone/Fax

Practice location:
  • Phone: 304-928-8766
  • Fax: 304-752-8536
Mailing address:
  • Phone: 304-928-8766
  • Fax: 304-752-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. MANDA MAE HALL-MULLINS
Title or Position: OWNER
Credential:
Phone: 304-928-8766