Provider Demographics
NPI:1700428851
Name:ENDURANCE MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:ENDURANCE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:KATHARINA
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-544-2405
Mailing Address - Street 1:700 BAKER RD STE 109
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1077
Mailing Address - Country:US
Mailing Address - Phone:757-544-2405
Mailing Address - Fax:
Practice Address - Street 1:700 BAKER RD STE 109
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1077
Practice Address - Country:US
Practice Address - Phone:757-544-2405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport