Organization
MEDTRAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CONNIE PIGG (OWNER)
(434) 572-3886
Entity
Organization
Contact information
Practice address
509 CHALMERS ST, SOUTH BOSTON, VA 24592-2401
(434) 572-3886
(434) 572-3606
Mailing address
PO BOX 14, ALTON, VA 24520-0014
(434) 572-3886
(434) 572-3606
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1218
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176878
ANTHEM MEDIGAP NUMBER
VA
01
—
P00433010
RAILROAD MEDICARE
VA
Enumeration date
01/04/2006
Last updated
01/18/2008
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