=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447736681
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YELLOW CAB OF VIRGINIA BEACH INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2018
-----------------------------------------------------
Last Update Date | 07/11/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6053 PROVIDENCE RD
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23464-3815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-460-0605
-----------------------------------------------------
Fax | 757-460-0622
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6053 PROVIDENCE RD
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23464-3815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-460-0605
-----------------------------------------------------
Fax | 757-460-0622
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | LILLIAN I LUCASH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-460-0605
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 344600000X
-----------------------------------------------------
Taxonomy Name | Taxi
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------