=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902560709
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HYLTON EXPRESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2021
-----------------------------------------------------
Last Update Date | 10/27/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 1ST ST
-----------------------------------------------------
City | MARTINSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24112-6301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-771-7077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3568
-----------------------------------------------------
City | MARTINSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24115-3568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-771-7077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DRIVER
-----------------------------------------------------
Name | CHRISTINA HYLTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 434-771-7077
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------