Provider Demographics
NPI:1477183812
Name:LIVELY MEDICAL TRANSPORT LLC.
Entity Type:Organization
Organization Name:LIVELY MEDICAL TRANSPORT LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:CASTEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-296-8088
Mailing Address - Street 1:442 OLD ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-2610
Mailing Address - Country:US
Mailing Address - Phone:804-296-8088
Mailing Address - Fax:
Practice Address - Street 1:442 OLD ORCHARD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:VA
Practice Address - Zip Code:22503-2610
Practice Address - Country:US
Practice Address - Phone:804-296-8088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)