=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497382337
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIVERSIFIED TRANSPORTATION SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2020
-----------------------------------------------------
Last Update Date | 07/19/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4940 PORTSMOUTH BLVD. #222
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-541-0803
-----------------------------------------------------
Fax | 804-548-4310
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4240 PORTSMOUTH BLVD # 222
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321-2129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-541-0803
-----------------------------------------------------
Fax | 804-548-4310
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING PARTNER
-----------------------------------------------------
Name | MS. KIANA CHILDS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-541-0803
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 347C00000X
-----------------------------------------------------
Taxonomy Name | Private Vehicle
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------