Provider Demographics
NPI:1508370958
Name:TRANSPORTER LLC
Entity Type:Organization
Organization Name:TRANSPORTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:VERNARD
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-363-7706
Mailing Address - Street 1:1500 RIVER TREE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-6139
Mailing Address - Country:US
Mailing Address - Phone:804-363-7706
Mailing Address - Fax:
Practice Address - Street 1:1500 RIVER TREE DR APT 102
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-6139
Practice Address - Country:US
Practice Address - Phone:804-363-7706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAN12-643343900000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)