Provider Demographics
NPI:1477110997
Name:TOTAL MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:TOTAL MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATREVA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-407-4757
Mailing Address - Street 1:913 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6201
Mailing Address - Country:US
Mailing Address - Phone:757-407-4757
Mailing Address - Fax:757-934-3389
Practice Address - Street 1:913 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6201
Practice Address - Country:US
Practice Address - Phone:757-407-4757
Practice Address - Fax:757-934-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)