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General NPI Number Information
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NPI Number | 1184715633
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Entity Type | Organization
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Legal Business Name | POTOMAC VALLEY TRANSIT AUTHORITY
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | GRANT COUNTY INDUSTRIAL PARK
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City | PETERSBURG
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State | WV
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Zip | 26847
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Country | US
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Telephone | 304-257-1414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 278
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City | PETERSBURG
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State | WV
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Zip | 26847
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Country | US
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Telephone | 304-257-1414
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Fax | 304-257-2804
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Authorized Official
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Title or Position | ASSISTANT MANAGER
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Name | MRS. JUANITA D LLOYD
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Credential |
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Telephone | 304-257-1414
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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 |
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License Number State | WV
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