Provider Demographics
NPI:1710448295
Name:INFINITY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:INFINITY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-640-1111
Mailing Address - Street 1:3416 STANSFIELD CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-6143
Mailing Address - Country:US
Mailing Address - Phone:804-640-1111
Mailing Address - Fax:
Practice Address - Street 1:3416 STANSFIELD CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-6143
Practice Address - Country:US
Practice Address - Phone:804-640-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)