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General NPI Number Information
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NPI Number | 1528400702
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Entity Type | Organization
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Legal Business Name | DELTA MEDICAL TRANSPORT, INC.
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 8305 WILLOW RIDGE PL
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3296
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Country | US
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Telephone | 804-755-7774
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Fax | 804-755-1709
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Provider Business Mailing Address
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Address Line | PO BOX 28723
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City | RICHMOND
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State | VA
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Zip | 23228-8723
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Country | US
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Telephone | 804-755-7774
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Fax | 804-755-7774
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ELAGIB M ELBASHIR
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Credential |
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Telephone | 804-755-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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