Provider Demographics
NPI:1376020206
Name:LENA PON US TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:LENA PON US TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGROVE MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-721-2058
Mailing Address - Street 1:818 TETON CIR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3390
Mailing Address - Country:US
Mailing Address - Phone:757-667-9121
Mailing Address - Fax:
Practice Address - Street 1:818 TETON CIR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3390
Practice Address - Country:US
Practice Address - Phone:757-667-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)