Provider Demographics
NPI:1043610736
Name:B.A.L.D. TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:B.A.L.D. TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-423-2253
Mailing Address - Street 1:645 CHURCH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:757-423-2253
Mailing Address - Fax:757-423-0090
Practice Address - Street 1:645 CHURCH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-423-2253
Practice Address - Fax:757-423-0090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B.A.L.D. TRANSPORTATION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle