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General NPI Number Information
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NPI Number | 1154870863
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Entity Type | Organization
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Legal Business Name | PIONEER SERVICES, LLC
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 484 MADDOX RD
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City | GLADYS
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State | VA
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Zip | 24554-3030
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Country | US
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Telephone | 434-473-3146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | NARUNA
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State | VA
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Zip | 24576-0073
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Country | US
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Telephone | 434-473-3146
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARRINGTON MENZEL
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Credential | QMHP
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Telephone | 434-473-3146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | S6069449
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License Number State | VA
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