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General NPI Number Information
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NPI Number | 1336952118
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Entity Type | Organization
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Legal Business Name | FLY GLIDE TRANSPORTATION, LLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1491 BROWNS CREEK RD
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City | BRODNAX
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State | VA
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Zip | 23920-3119
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Country | US
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Telephone | 434-247-2009
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Fax |
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Provider Business Mailing Address
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Address Line | 1491 BROWNS CREEK RD
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City | BRODNAX
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State | VA
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Zip | 23920-3119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | ALIYAH JONES
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Credential |
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Telephone | 434-247-2009
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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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