Provider Demographics
NPI:1619361466
Name:MED-TRIP EXPRESS LLC
Entity Type:Organization
Organization Name:MED-TRIP EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-783-7932
Mailing Address - Street 1:626 PEAVLER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-2038
Mailing Address - Country:US
Mailing Address - Phone:276-783-7932
Mailing Address - Fax:276-783-3955
Practice Address - Street 1:318 CHATHAM HILL RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-2816
Practice Address - Country:US
Practice Address - Phone:276-706-7619
Practice Address - Fax:276-783-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)