Provider Demographics
NPI:1841781176
Name:VIRGINIA MEDICAL TRANSPORT, LLC.
Entity Type:Organization
Organization Name:VIRGINIA MEDICAL TRANSPORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP, REVENUE MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-703-2294
Mailing Address - Street 1:PO BOX 744719
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4719
Mailing Address - Country:US
Mailing Address - Phone:833-703-2294
Mailing Address - Fax:
Practice Address - Street 1:360 HERNDON PKWY STE 700
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170
Practice Address - Country:US
Practice Address - Phone:571-323-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN MEDICAL RESPONSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-22
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport