Provider Demographics
NPI:1598254039
Name:TRANSPORTATION BLUE LLC
Entity Type:Organization
Organization Name:TRANSPORTATION BLUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-721-3835
Mailing Address - Street 1:9291 LAUREL GROVE RD STE 11
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2969
Mailing Address - Country:US
Mailing Address - Phone:804-721-3835
Mailing Address - Fax:
Practice Address - Street 1:9291 LAUREL GROVE RD STE 11
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2969
Practice Address - Country:US
Practice Address - Phone:804-721-3835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)