MEDICARE: BLC TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi	T65-91-4229	VA

General Provider Information

NPI Number	:	1033486410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLC TRANSPORTATION

Provider Business Mailing Address
First Line	:	1800 CHEVELLE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5639
Country	:	US
Telephone Number	:	804-433-7553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 CHEVELLE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5639
Country	:	US
Telephone Number	:	804-433-7553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. BRANDI L CLAXTON
Credential	:
Telephone Number	:	804-433-7553

Provider Enumeration Date	:	11/29/2011
Last Update Date	:	11/29/2011

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