Provider Demographics
NPI:1750911657
Name:MAGNUM HEALTH TRANSPORTATION LLC
Entity type:Organization
Organization Name:MAGNUM HEALTH TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:ANQUAIN
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-909-0172
Mailing Address - Street 1:8137 SEAVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5109
Mailing Address - Country:US
Mailing Address - Phone:804-909-0172
Mailing Address - Fax:
Practice Address - Street 1:8137 SEAVIEW DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838-5109
Practice Address - Country:US
Practice Address - Phone:804-909-0172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-19
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)