Provider Demographics
NPI:1407456544
Name:LAVENDER NON-MEDICAL TRANSPORTATIONS LLC
Entity Type:Organization
Organization Name:LAVENDER NON-MEDICAL TRANSPORTATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-243-5709
Mailing Address - Street 1:901 S HIGHLAND ST STE 333
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-2459
Mailing Address - Country:US
Mailing Address - Phone:571-243-5709
Mailing Address - Fax:
Practice Address - Street 1:901 S HIGHLAND ST STE 333
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-2459
Practice Address - Country:US
Practice Address - Phone:571-243-5709
Practice Address - Fax:571-483-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)