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Organization

A & D MOBILITY SERVICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DERVENT DACOSTA (OWNER)
(571) 589-6509
Entity
Organization

Contact information

Practice address
1376 OLD BRIDGE RD # 101, WOODBRIDGE, VA 22192-2708
(571) 589-6509
Mailing address
1376 OLD BRIDGE RD # 101, WOODBRIDGE, VA 22192-2708
(571) 589-6509

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
10/06/2016
Last updated
10/06/2016
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