Provider Demographics
NPI:1306207444
Name:VAN'S MED TEC TRANSPORT, LLC
Entity Type:Organization
Organization Name:VAN'S MED TEC TRANSPORT, LLC
Other - Org Name:VAN'S MED-TEC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-836-5252
Mailing Address - Street 1:3611 MOUNT CROSS RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-5169
Mailing Address - Country:US
Mailing Address - Phone:434-836-5252
Mailing Address - Fax:434-321-1675
Practice Address - Street 1:3611 MOUNT CROSS RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5169
Practice Address - Country:US
Practice Address - Phone:434-836-5252
Practice Address - Fax:434-321-1675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)