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General NPI Number Information
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NPI Number | 1619361466
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Entity Type | Organization
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Legal Business Name | MED-TRIP EXPRESS LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 318 CHATHAM HILL RD
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City | MARION
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State | VA
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Zip | 24354-2816
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Country | US
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Telephone | 276-706-7619
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Fax | 276-783-3955
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Provider Business Mailing Address
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Address Line | 626 PEAVLER ST
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City | MARION
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State | VA
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Zip | 24354-2038
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Country | US
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Telephone | 276-783-7932
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Fax | 276-783-3955
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Authorized Official
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Title or Position | OWNER
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Name | MARY GUY
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Credential |
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Telephone | 276-783-7932
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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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