MEDICARE: DANA L CRAWLEY

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)	1030277	VA

General Provider Information

NPI Number	:	1245710912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA L CRAWLEY

Provider Business Mailing Address
First Line	:	1416 HARWOOD ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-7530
Country	:	US
Telephone Number	:	804-939-8114
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 HARWOOD ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-7530
Country	:	US
Telephone Number	:	804-939-8114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	08/21/2018

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Directions to “ DANA L CRAWLEY ” Practice Location

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