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General NPI Number Information
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NPI Number | 1649862319
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Entity Type | Organization
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Legal Business Name | DIAMOND TRANSPORT OF VA, LLC
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 731 WALKER RD STE D2
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City | GREAT FALLS
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State | VA
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Zip | 22066-2834
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Country | US
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Telephone | 703-488-8869
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Fax |
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Provider Business Mailing Address
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Address Line | 731 WALKER RD STE D2
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City | GREAT FALLS
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State | VA
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Zip | 22066-2834
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Country | US
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Telephone | 703-488-8869
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Fax | 703-935-6111
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Authorized Official
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Title or Position | CEO/OWNER
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Name | EUGENE MCDUFFIE IV
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Credential |
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Telephone | 703-488-8869
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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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