Provider Demographics
NPI:1932505823
Name:CGREEN TRANSPORT LLC
Entity Type:Organization
Organization Name:CGREEN TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-696-2282
Mailing Address - Street 1:2011 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-3027
Mailing Address - Country:US
Mailing Address - Phone:757-696-2282
Mailing Address - Fax:757-966-9199
Practice Address - Street 1:2011 QUEEN ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3027
Practice Address - Country:US
Practice Address - Phone:757-696-2282
Practice Address - Fax:757-966-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)