Provider Demographics
NPI:1821648452
Name:GASBURG EXPRESS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GASBURG EXPRESS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:434-774-4534
Mailing Address - Street 1:2100 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23857-2328
Mailing Address - Country:US
Mailing Address - Phone:434-774-4534
Mailing Address - Fax:434-577-9344
Practice Address - Street 1:2100 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:GASBURG
Practice Address - State:VA
Practice Address - Zip Code:23857-2328
Practice Address - Country:US
Practice Address - Phone:434-774-4534
Practice Address - Fax:434-577-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)