Provider Demographics
NPI:1659893394
Name:FAITH MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:FAITH MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DODOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-606-7158
Mailing Address - Street 1:19235 BUNA ST
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172
Mailing Address - Country:US
Mailing Address - Phone:703-606-7158
Mailing Address - Fax:703-221-6580
Practice Address - Street 1:19235 BUNA ST
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2426
Practice Address - Country:US
Practice Address - Phone:703-606-7158
Practice Address - Fax:703-221-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)