Provider Demographics
NPI:1346884855
Name:DRAGONFLY MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:DRAGONFLY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OBERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-284-3532
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:VA
Mailing Address - Zip Code:22920-0038
Mailing Address - Country:US
Mailing Address - Phone:434-284-3532
Mailing Address - Fax:
Practice Address - Street 1:2856 AFTON MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:VA
Practice Address - Zip Code:22920-2209
Practice Address - Country:US
Practice Address - Phone:434-284-3532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)