=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043131394
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY COALITION OF SUSSEX VIRGINIA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2026
-----------------------------------------------------
Last Update Date | 07/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9436 MAYES STREET
-----------------------------------------------------
City | JARRATT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23867
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-255-9680
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9436 MAYES STREET
-----------------------------------------------------
City | JARRATT
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23867
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-255-9680
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | ROBERT E. HAMLIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 540-798-0036
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------