Provider Demographics
NPI:1972014009
Name:PROFESSIONAL TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:PROFESSIONAL TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISHTIAQ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-484-2266
Mailing Address - Street 1:7800 WALKENHUT DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-3572
Mailing Address - Country:US
Mailing Address - Phone:804-484-2266
Mailing Address - Fax:
Practice Address - Street 1:7800 WALKENHUT DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-3572
Practice Address - Country:US
Practice Address - Phone:804-484-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)