Provider Demographics
NPI:1477233211
Name:LIFE CYCLE TRANSPORT LLC
Entity Type:Organization
Organization Name:LIFE CYCLE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EVERETTE
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:NEMT
Authorized Official - Phone:276-806-0221
Mailing Address - Street 1:2494 DANIELS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24078-1368
Mailing Address - Country:US
Mailing Address - Phone:276-806-0221
Mailing Address - Fax:
Practice Address - Street 1:2494 DANIELS CREEK RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24078-1368
Practice Address - Country:US
Practice Address - Phone:276-806-0221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)