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General NPI Number Information
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NPI Number | 1649784901
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Entity Type | Organization
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Legal Business Name | LUCY TRANSPORTATION INC
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Dates
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Enumeration Date | 11/24/2017
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Last Update Date | 11/24/2017
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Provider Practice Location Address
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Address Line | 3451 KILBURN CIR APT 722
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City | HENRICO
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State | VA
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Zip | 23233-1140
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Country | US
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Telephone | 804-263-8205
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Fax | 804-998-3333
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Provider Business Mailing Address
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Address Line | 3451 KILBURN CIR APT 722
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City | HENRICO
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State | VA
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Zip | 23233-1140
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Country | US
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Telephone | 804-263-8205
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Fax |
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Authorized Official
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Title or Position | VICE PRESEDANT
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Name | HABETAMU FISSEHA AYEHU
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Credential |
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Telephone | 804-998-3012
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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 | 623
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License Number State | VA
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