Provider Demographics
NPI:1649715707
Name:RENMAX TRANSPORT LLC
Entity type:Organization
Organization Name:RENMAX TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADJEI
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:703-932-8184
Mailing Address - Street 1:1711 GRAYWOOD WAY NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6636
Mailing Address - Country:US
Mailing Address - Phone:703-932-8184
Mailing Address - Fax:703-547-8098
Practice Address - Street 1:1711 GRAYWOOD WAY NE
Practice Address - Street 2:1711
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6636
Practice Address - Country:US
Practice Address - Phone:703-932-8184
Practice Address - Fax:703-547-8098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)