MEDICARE: STONERIDGE TRANSPORTATION SERVICES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1053835892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONERIDGE TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	4324 KENMARE CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23234-3080
Country	:	US
Telephone Number	:	804-325-9893
Fax Number	:

Provider Business Practice Location Address
First Line	:	4324 KENMARE CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23234-3080
Country	:	US
Telephone Number	:	804-325-9893
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KATE CANN
Credential	:	ADMINISTRATOR
Telephone Number	:	804-325-9893

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	07/21/2022

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