Provider Demographics
NPI:1306224241
Name:BANKS, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BANKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 LYNDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5217
Mailing Address - Country:US
Mailing Address - Phone:804-852-1347
Mailing Address - Fax:804-353-3588
Practice Address - Street 1:9323 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4942
Practice Address - Country:US
Practice Address - Phone:804-353-3585
Practice Address - Fax:804-353-3588
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)