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Organization

D19 TRANSPORTATION SERVICE INC.

Active
Other names
D19 Cab Service
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EARL A BLACKMAN ATP (PRESIDENT)
(434) 632-1157
Entity
Organization

Contact information

Practice address
10004 BLUE STAR HWY, STONY CREEK, VA 23882-3218
(434) 632-1157
(866) 230-2666
Mailing address
112 LAVENDER DRIVE, A, MAX MEADOWS, VA 24360
(434) 623-1157
(866) 230-2666

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
24510
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
66178
VIRGINIA PREMIER HEALTH PLAN
VA
Enumeration date
07/29/2015
Last updated
07/29/2015
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