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General NPI Number Information
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NPI Number | 1144225533
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Entity Type | Organization
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Legal Business Name | MEDICAL TRANSPORTATION SERVICES, LLC
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 360 HERNDON PKWY STE 1200
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City | HERNDON
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State | VA
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Zip | 20170-4824
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Country | US
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Telephone | 571-323-0800
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Fax | 571-323-0801
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Provider Business Mailing Address
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Address Line | 360 HERNDON PKWY STE 1200
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City | HERNDON
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State | VA
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Zip | 20170-4824
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Country | US
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Telephone | 571-323-0800
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Fax | 571-323-0801
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Authorized Official
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Title or Position | DIRECTOR, CHIEF OF OPERATIONS
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Name | MR. RANDOLPH THOMAS BRETON
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Credential | MEDIC
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Telephone | 571-323-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0540402
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License Number State | VA
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