Provider Demographics
NPI:1891418844
Name:RECKLESS INC. DBA REAL TIME TRANSPORTATION
Entity Type:Organization
Organization Name:RECKLESS INC. DBA REAL TIME TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAUGHTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-453-3985
Mailing Address - Street 1:1500 SHIPYARD RD STE D1216
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-5516
Mailing Address - Country:US
Mailing Address - Phone:888-453-3985
Mailing Address - Fax:
Practice Address - Street 1:1216 E EVA BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-6210
Practice Address - Country:US
Practice Address - Phone:175-746-9441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)