Organization
MTI OF VIRGINIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEVELAND C. MABRY (VICE PRESIDENT)
(757) 245-0797
Entity
Organization
Contact information
Practice address
1001 WICKHAM AVE, NEWPORT NEWS, VA 23607-6438
(757) 245-0797
(757) 245-0798
Mailing address
1001 WICKHAM AVE, NEWPORT NEWS, VA 23607-6438
(757) 245-0797
(757) 245-0798
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
17893
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601007
CAGE NUMBER 3W5D3
VA
Enumeration date
04/12/2007
Last updated
08/22/2020
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