MEDICARE: BLESSING TRANSIT 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1063983476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSING TRANSIT LLC

Provider Business Mailing Address
First Line	:	4909 HUNTER HILL TER
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-2649
Country	:	US
Telephone Number	:	804-405-0003
Fax Number	:

Provider Business Practice Location Address
First Line	:	11535 NUCKOLS RD STE E
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5671
Country	:	US
Telephone Number	:	804-372-8188
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. DESIREE AQUINO
Credential	:
Telephone Number	:	804-372-8188

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	05/02/2019

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