Provider Demographics
NPI:1285190371
Name:INNOVATIVE COMMUNITY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:INNOVATIVE COMMUNITY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-293-2449
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:VA
Mailing Address - Zip Code:24127-0544
Mailing Address - Country:US
Mailing Address - Phone:540-293-2449
Mailing Address - Fax:
Practice Address - Street 1:799 UNION ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5122
Practice Address - Country:US
Practice Address - Phone:540-293-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)