Provider Demographics
NPI:1891481339
Name:BLOSSOM OF HOPE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:BLOSSOM OF HOPE MEDICAL TRANSPORTATION
Other - Org Name:BLOSSOM OF HOPE MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:FREMA
Authorized Official - Last Name:AGYEI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-479-1117
Mailing Address - Street 1:9300 FOREST POINT CIR STE 131
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4743
Mailing Address - Country:US
Mailing Address - Phone:703-479-1117
Mailing Address - Fax:703-479-2191
Practice Address - Street 1:9300 FOREST POINT CIR STE 131
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4743
Practice Address - Country:US
Practice Address - Phone:703-479-1117
Practice Address - Fax:703-479-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)