=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992152664
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARIES TRANSPORT SERVICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2016
-----------------------------------------------------
Last Update Date | 05/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 PANTIGO LN APT 103
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-8483
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-717-1548
-----------------------------------------------------
Fax | 757-351-6979
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 PANTIGO LN APT 103
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-8483
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-717-1548
-----------------------------------------------------
Fax | 757-351-6979
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. STEVE ALLEN JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-717-1548
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------