Healthcare Provider Details

I. General information

NPI: 1437426004
Provider Name (Legal Business Name): FREDERICK KIRBY GARRETT TRANSPORTATION
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. FREDERICK KIRBY GARRETT

II. Dates (important events)

Enumeration Date: 11/25/2011
Last Update Date: 11/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WILSON ST
MARTINSBURG WV
25401-3022
US

IV. Provider business mailing address

142 BAKER ST
WINCHESTER VA
22601-5035
US

V. Phone/Fax

Practice location:
  • Phone: 304-441-6000
  • Fax:
Mailing address:
  • Phone: 540-441-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number2251-8418
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: