Provider Demographics
NPI:1376982538
Name:LV TRANSPORTATION
Entity Type:Organization
Organization Name:LV TRANSPORTATION
Other - Org Name:LV TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERY
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-262-2470
Mailing Address - Street 1:505 W ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-6542
Mailing Address - Country:US
Mailing Address - Phone:480-262-2470
Mailing Address - Fax:
Practice Address - Street 1:505 W ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-6542
Practice Address - Country:US
Practice Address - Phone:480-262-2470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)