Provider Demographics
NPI:1821422148
Name:BLESSED TRANSPORTATION LLC
Entity Type:Organization
Organization Name:BLESSED TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-387-4175
Mailing Address - Street 1:2006 ALLISON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:WV
Mailing Address - Zip Code:26034-2069
Mailing Address - Country:US
Mailing Address - Phone:304-387-4175
Mailing Address - Fax:304-387-4243
Practice Address - Street 1:2006 ALLISON RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:WV
Practice Address - Zip Code:26034-2069
Practice Address - Country:US
Practice Address - Phone:304-387-4175
Practice Address - Fax:304-387-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2288-4440343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)