Organization
MELANIN EXCELLENCE MEDICAL TRANSPORTATION CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE L NEELY (CEO)
(757) 232-6516
Entity
Organization
Contact information
Practice address
4418 EAST CLAIBORNE SQ, SUITE 334, HAMPTON, VA 23666
(757) 379-5111
Mailing address
1106 BUOY CT, SUFFOLK, VA 23435-2845
(757) 232-6516
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578032934
—
VA
Enumeration date
04/30/2019
Last updated
04/30/2019
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