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General NPI Number Information
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NPI Number | 1194365395
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Entity Type | Organization
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Legal Business Name | HEAVEN5ENT LLC
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 3241 TWINFLOWER LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-5917
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Country | US
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Telephone | 757-300-7747
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Fax | 757-689-6180
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Provider Business Mailing Address
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Address Line | 3241 TWINFLOWER LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-5917
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Country | US
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Telephone | 757-300-7747
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Fax | 757-689-6180
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE JONES
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Credential |
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Telephone | 757-300-7747
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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 |
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