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General NPI Number Information
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NPI Number | 1396191870
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Entity Type | Organization
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Legal Business Name | ISG TRANSPORT, LLC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 7653 FRAMINGHAM CT.
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City | GAINESVILLE
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State | VA
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Zip | 20155
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Country | US
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Telephone | 571-248-6181
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Fax |
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Provider Business Mailing Address
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Address Line | 7653 FRAMINGHAM CT
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City | GAINESVILLE
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State | VA
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Zip | 20155-4864
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Country | US
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Telephone | 571-248-6181
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS IRIS A BURGOS
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Credential |
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Telephone | 571-248-6181
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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 | 16L07560
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License Number State | VA
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