Provider Demographics
NPI:1508413329
Name:ORANGE, PRESTON L
Entity Type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:L
Last Name:ORANGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 PROCTORS RUN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23237-2773
Mailing Address - Country:US
Mailing Address - Phone:804-937-2958
Mailing Address - Fax:804-231-1718
Practice Address - Street 1:8812 PROCTORS RUN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23237-2773
Practice Address - Country:US
Practice Address - Phone:804-937-2958
Practice Address - Fax:804-231-1718
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)