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Organization

PRIDE TRANSPORTATION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LATARSHA PRIDE (OWNER - MEMBER)
(540) 419-7766
Entity
Organization

Contact information

Practice address
27 PENDLETON RD, FREDERICKSBURG, VA 22405-3040
(540) 419-7766
(540) 373-7766
Mailing address
27 PENDLETON RD, FREDERICKSBURG, VA 22405-3040
(540) 419-7766
(540) 373-7766

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T60873761
VA
347C00000X
Private Vehicle
T60873761
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IR-292
VIRGINIA COMMON CARRIER OVER IRREGULAR ROUTES AUTHORIZED CERTIFICATE
VA
Enumeration date
04/05/2016
Last updated
04/21/2016
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