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General NPI Number Information
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NPI Number | 1528625746
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Entity Type | Organization
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Legal Business Name | UNITSTATEPVTTRANSPORTATION
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 19 MAPLE ST
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978-2010
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Country | US
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Telephone | 631-205-8683
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Fax | 610-205-9716
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Provider Business Mailing Address
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Address Line | PO BOX 636
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City | WESTHAMPTON
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State | NY
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Zip | 11977-0636
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Country | US
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Telephone | 631-205-8673
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Fax | 610-205-9716
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRYAN ANTHONY WRIGHT
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Credential |
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Telephone | 631-205-8673
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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 |
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License Number State |
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