Provider Demographics
NPI:1952968471
Name:BLAIRS TRANSPORTATION COMPANY LLCC
Entity Type:Organization
Organization Name:BLAIRS TRANSPORTATION COMPANY LLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LLC
Authorized Official - Phone:434-709-4262
Mailing Address - Street 1:181 BLAIRS CT LOT 51
Mailing Address - Street 2:
Mailing Address - City:BLAIRS
Mailing Address - State:VA
Mailing Address - Zip Code:24527-2305
Mailing Address - Country:US
Mailing Address - Phone:434-709-4262
Mailing Address - Fax:
Practice Address - Street 1:181 BLAIRS CT LOT 51
Practice Address - Street 2:
Practice Address - City:BLAIRS
Practice Address - State:VA
Practice Address - Zip Code:24527-2305
Practice Address - Country:US
Practice Address - Phone:434-709-4262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760988687Medicaid