Provider Demographics
NPI:1558936518
Name:SCRUBS MEDICAL TRANSPORT COMPANY LLC
Entity Type:Organization
Organization Name:SCRUBS MEDICAL TRANSPORT COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-213-5157
Mailing Address - Street 1:691 PINECREST AVE APT C5
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-2857
Mailing Address - Country:US
Mailing Address - Phone:434-213-5157
Mailing Address - Fax:
Practice Address - Street 1:691 PINECREST AVE APT C5
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-2857
Practice Address - Country:US
Practice Address - Phone:434-213-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)