Provider Demographics
NPI:1326748120
Name:ECHELONCARE MEDICALTRANSPORT LLC
Entity Type:Organization
Organization Name:ECHELONCARE MEDICALTRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVON
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-680-1931
Mailing Address - Street 1:3828 LAMPLIGHTER CT
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-2283
Mailing Address - Country:US
Mailing Address - Phone:917-680-1931
Mailing Address - Fax:
Practice Address - Street 1:3828 LAMPLIGHTER CT
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2283
Practice Address - Country:US
Practice Address - Phone:917-680-1931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)