Organization
HEAVEN TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YONAS ZERAI TEWOLDEMEDHIN (CEO)
(703) 989-0589
Entity
Organization
Contact information
Practice address
16440 STEDHAM CIR APT 10116440, DUMFRIES, VA 22025-1560
(703) 989-0589
Mailing address
16440 STEDHAM CIR APT 10116440, DUMFRIES, VA 22025-1560
(703) 989-0589
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46565695604
—
VA
Enumeration date
09/14/2020
Last updated
09/14/2020
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