Provider Demographics
NPI:1679333793
Name:VA MEDITRANS, LLC
Entity type:Organization
Organization Name:VA MEDITRANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-888-7051
Mailing Address - Street 1:5106 WATERLICK RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-3941
Mailing Address - Country:US
Mailing Address - Phone:434-849-8829
Mailing Address - Fax:434-849-8831
Practice Address - Street 1:5106 WATERLICK RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-3941
Practice Address - Country:US
Practice Address - Phone:434-849-8829
Practice Address - Fax:434-849-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)