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General NPI Number Information
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NPI Number | 1417409475
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Entity Type | Organization
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Legal Business Name | J&J AMBULETTE SERVICE, LLC
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 12266 PRINCE GEORGE DR
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City | DISPUTANTA
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State | VA
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Zip | 23842-4404
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Country | US
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Telephone | 804-861-1266
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Fax | 804-861-6221
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Provider Business Mailing Address
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Address Line | 12266 PRINCE GEORGE DR
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City | DISPUTANTA
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State | VA
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Zip | 23842-4404
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Country | US
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Telephone | 804-861-1266
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Fax | 804-861-6221
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Authorized Official
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Title or Position | OWNER
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Name | JOHN E THOMAS JR.
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Credential |
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Telephone | 804-502-0543
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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 | 83
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License Number State | VA
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