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General NPI Number Information
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NPI Number | 1285148346
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE MEDICAL TRANSPORT SERVICES LLC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 11774 PIKA DR
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City | WALDORF
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State | MD
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Zip | 20602-2777
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Country | US
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Telephone | 240-754-7870
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Fax | 240-448-3609
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Provider Business Mailing Address
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Address Line | PO BOX 500
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-0500
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Country | US
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Telephone | 240-754-7870
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Fax | 240-448-3609
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Authorized Official
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Title or Position | OWNER
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Name | DONALD DEGRAVES
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Credential |
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Telephone | 240-754-7870
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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 | 144
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License Number State | MD
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