Provider Demographics
NPI:1639828114
Name:TRANSFORMATION NON-EMERGENCY MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:TRANSFORMATION NON-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGIANA
Authorized Official - Middle Name:ONIKE
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-363-7314
Mailing Address - Street 1:12724 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2164
Mailing Address - Country:US
Mailing Address - Phone:571-363-7314
Mailing Address - Fax:
Practice Address - Street 1:12724 NORWOOD DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2164
Practice Address - Country:US
Practice Address - Phone:571-363-7314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)