Provider Demographics
NPI:1801492061
Name:MEDEX-VA MEDICAL EXPRESS LLC
Entity type:Organization
Organization Name:MEDEX-VA MEDICAL EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-615-6506
Mailing Address - Street 1:2526 DORNOCH RD # 2526
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5115
Mailing Address - Country:US
Mailing Address - Phone:804-615-6506
Mailing Address - Fax:
Practice Address - Street 1:2817 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4411
Practice Address - Country:US
Practice Address - Phone:804-615-6506
Practice Address - Fax:804-447-9829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB63616223OtherDRIVERS LICENCE