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General NPI Number Information
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NPI Number | 1891234167
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Entity Type | Organization
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Legal Business Name | IDS GROUP LLC
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Dates
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Enumeration Date | 02/19/2017
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Last Update Date | 02/19/2017
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Provider Practice Location Address
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Address Line | 3 DUNDEE AVE
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City | RICHMOND
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State | VA
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Zip | 23225-4801
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Country | US
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Telephone | 804-647-4413
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Fax |
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Provider Business Mailing Address
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Address Line | 12220 CHATTANOOGA PLZ STE 154
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4865
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Country | US
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Telephone | 804-647-4413
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MR. CHRISON RATLIFF
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Credential |
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Telephone | 804-647-4413
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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 | VA
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