Provider Demographics
NPI:1033427448
Name:CHARITY TRANSPORT, LLC
Entity Type:Organization
Organization Name:CHARITY TRANSPORT, LLC
Other - Org Name:CHARITY CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-309-3975
Mailing Address - Street 1:1225 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2041
Mailing Address - Country:US
Mailing Address - Phone:757-226-9916
Mailing Address - Fax:757-512-8802
Practice Address - Street 1:1637 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4038
Practice Address - Country:US
Practice Address - Phone:757-226-9916
Practice Address - Fax:757-512-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171533251E00000X
VA202343800000X, 343900000X, 347C00000X
VA905705343800000X, 343900000X, 347C00000X
VA20276344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0153841405OtherAPI