Organization
MAR MAC TRANSPORTATION SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW T ELLIS (AR MGR)
(757) 655-0029
Entity
Organization
Contact information
Practice address
5000 INCUBATOR RD, STE 101, HAMPTON, VA 23661-1347
(866) 343-7153
(757) 787-9436
Mailing address
PO BOX 538341, ATLANTA, GA 30353-8341
(866) 343-7153
(757) 787-9436
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009012648
—
VA
01
—
317940
ANTHEM BCBS
VA
01
—
590013449
RAILROAD MEDICARE
—
Enumeration date
05/24/2005
Last updated
09/12/2012
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