Organization
AMAZING GRACE TRANSPORT SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNETT STACEY-ANN TYNDALE (OWNER)
(757) 774-1759
Entity
Organization
Contact information
Practice address
5293 PIRATA PL, VIRGINIA BEACH, VA 23462-1980
(757) 524-5859
Mailing address
5293 PIRATA PL, VIRGINIA BEACH, VA 23462-1980
(757) 524-5859
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
343900000X
TRANSPORTATION SERVICE NON EMERGENCY MEDICAL TRANSPORT VAN
VA
Enumeration date
05/04/2019
Last updated
05/04/2019
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