Provider Demographics
NPI:1629674833
Name:A PROPHET NON EMERGENCY TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:A PROPHET NON EMERGENCY TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:UPSHAW-BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-243-1034
Mailing Address - Street 1:PO BOX 8916
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-0616
Mailing Address - Country:US
Mailing Address - Phone:804-243-1034
Mailing Address - Fax:844-364-8887
Practice Address - Street 1:6972 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1654
Practice Address - Country:US
Practice Address - Phone:804-243-1034
Practice Address - Fax:844-364-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle