Provider Demographics
NPI:1356845135
Name:VA COURIER EXPRESS, LLC
Entity type:Organization
Organization Name:VA COURIER EXPRESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JARVARES
Authorized Official - Middle Name:Q
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-312-0408
Mailing Address - Street 1:350 LIMESTONE PL
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-5150
Mailing Address - Country:US
Mailing Address - Phone:770-312-0408
Mailing Address - Fax:
Practice Address - Street 1:350 LIMESTONE PL
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-5150
Practice Address - Country:US
Practice Address - Phone:770-312-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VA COURIER EXPRESS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-19
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherSTATE OF GEORGIA