Provider Demographics
NPI:1003335167
Name:RVA TRANSPORT, INC.
Entity Type:Organization
Organization Name:RVA TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADA
Authorized Official - Middle Name:QASSIM
Authorized Official - Last Name:ALKHAFAJI
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:804-728-5011
Mailing Address - Street 1:830 BRASSIE LN APT F
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7425
Mailing Address - Country:US
Mailing Address - Phone:804-728-5011
Mailing Address - Fax:
Practice Address - Street 1:830 BRASSIE LN, APT F
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059
Practice Address - Country:US
Practice Address - Phone:804-728-5011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA002-00630856343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)