Provider Demographics
NPI:1245756196
Name:R3A LOGISTICS LLC
Entity Type:Organization
Organization Name:R3A LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLAWON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-301-8262
Mailing Address - Street 1:9343 MINERAL ROCK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2073
Mailing Address - Country:US
Mailing Address - Phone:401-301-8262
Mailing Address - Fax:
Practice Address - Street 1:3419 VIRGINIA BEACH BLVD # 5010
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4419
Practice Address - Country:US
Practice Address - Phone:401-301-8262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)