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General NPI Number Information
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NPI Number | 1316334170
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Entity Type | Organization
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Legal Business Name | DELTA MEDICAL TRANSPORT
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 4795 BETHLEHEM RD SUITE C
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City | RICHMOND
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State | VA
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Zip | 23230-2516
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Country | US
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Telephone | 804-755-7774
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Fax | 804-755-1709
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Provider Business Mailing Address
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Address Line | 4795 BETHLEHEM RD SUITE C
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City | RICHMOND
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State | VA
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Zip | 23230-2516
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Country | US
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Telephone | 804-755-7774
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Fax | 804-755-1709
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. AMY VALENTINE MABE
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Credential |
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Telephone | 804-755-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 139
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License Number State | VA
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