MEDICARE: DAVID BANKS

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	:	1306224241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BANKS

Provider Business Mailing Address
First Line	:	11160 LYNDENWOOD DR
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838-5217
Country	:	US
Telephone Number	:	804-852-1347
Fax Number	:	804-353-3588

Provider Business Practice Location Address
First Line	:	9323 MIDLOTHIAN TPKE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-353-3585
Fax Number	:	804-353-3588

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

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	05/12/2015

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Directions to “ DAVID BANKS ” Practice Location

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