MEDICARE: MR. PRESTON L ORANGE

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	:	1508413329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PRESTON L ORANGE

Provider Business Mailing Address
First Line	:	8812 PROCTORS RUN DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23237-2773
Country	:	US
Telephone Number	:	804-937-2958
Fax Number	:	804-231-1718

Provider Business Practice Location Address
First Line	:	8812 PROCTORS RUN DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23237-2773
Country	:	US
Telephone Number	:	804-937-2958
Fax Number	:	804-231-1718

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

Provider Enumeration Date	:	08/26/2019
Last Update Date	:	08/26/2019

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Directions to “ MR. PRESTON L ORANGE ” Practice Location

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