Provider Demographics
NPI:1326523275
Name:RVA MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:RVA MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-332-6739
Mailing Address - Street 1:621 WESTOVER HILLS BLVD APT K
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4561
Mailing Address - Country:US
Mailing Address - Phone:678-332-6739
Mailing Address - Fax:
Practice Address - Street 1:621 WESTOVER HILLS BLVD APT K
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4561
Practice Address - Country:US
Practice Address - Phone:678-332-6739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)