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Organization

INDEPENDENT CAPACITY TRANSPORTATION SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PASCAL THEBAUD (EXECUTIVE DIRECTOR)
(804) 520-7773
Entity
Organization

Contact information

Practice address
16017 CONTINENTAL BLVD, SOUTH CHESTERFIELD, VA 23834-5900
(804) 520-7773
(804) 214-2177
Mailing address
PO BOX 3163, PETERSBURG, VA 23805-3163
(804) 520-7773
(804) 214-2177

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
04/14/2015
Last updated
04/14/2015
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