Provider Demographics
NPI:1942724026
Name:EMMANUEL MEDICAL TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:EMMANUEL MEDICAL TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-582-4882
Mailing Address - Street 1:2603 GLENRIVER WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-5178
Mailing Address - Country:US
Mailing Address - Phone:703-582-4482
Mailing Address - Fax:
Practice Address - Street 1:2603 GLENRIVER WAY
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-5178
Practice Address - Country:US
Practice Address - Phone:703-582-4482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)