Provider Demographics
NPI:1336826957
Name:STELLAR SERVICES OF VIRGINIA LLC
Entity Type:Organization
Organization Name:STELLAR SERVICES OF VIRGINIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-449-0229
Mailing Address - Street 1:1725 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23523-2337
Mailing Address - Country:US
Mailing Address - Phone:757-835-8440
Mailing Address - Fax:
Practice Address - Street 1:1725 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23523-2337
Practice Address - Country:US
Practice Address - Phone:757-835-8440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)