MEDICARE: GMA INTERVENTIONS, 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)
2	251S00000X	Community/Behavioral Health Agency	0710102083	VA

General Provider Information

NPI Number	:	1477925659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GMA INTERVENTIONS, LLC

Provider Business Mailing Address
First Line	:	870 NORTH NEWTOWN RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1398
Country	:	US
Telephone Number	:	757-490-1056
Fax Number	:	757-490-1091

Provider Business Practice Location Address
First Line	:	870 NORTH NEWTOWN RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1398
Country	:	US
Telephone Number	:	757-490-1056
Fax Number	:	757-490-1091

Authorized Official
Title or Position	:	COO
Name	:	MELISSA ALEXANDER
Credential	:	CSAC
Telephone Number	:	757-490-1056

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	10/17/2017

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