Provider Demographics
NPI:1891216933
Name:BLACK TOP TOWN CAR SERVICE LLC
Entity Type:Organization
Organization Name:BLACK TOP TOWN CAR SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-724-9999
Mailing Address - Street 1:410 MILLHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-0882
Mailing Address - Country:US
Mailing Address - Phone:757-724-9999
Mailing Address - Fax:
Practice Address - Street 1:410 MILLHOUSE CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-0882
Practice Address - Country:US
Practice Address - Phone:757-724-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)