MEDICARE: ADAPTIVE ACCOMMODATIONS RESIDENTIAL

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	:	1790320778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPTIVE ACCOMMODATIONS RESIDENTIAL

Provider Business Mailing Address
First Line	:	4016 MACARTHUR AVE APT B
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4058
Country	:	US
Telephone Number	:	804-386-4018
Fax Number	:

Provider Business Practice Location Address
First Line	:	4016 MACARTHUR AVE APT B
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4058
Country	:	US
Telephone Number	:	804-386-4018
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/OPERATOR
Name	:	MR. ANTHONY COTTON
Credential	:
Telephone Number	:	804-386-4018

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	11/13/2019

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