Organization
TRICARE MEDICAL TRANSPORTATION SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SIMONE D KING (OWNER/CEO)
(804) 735-3703
Entity
Organization
Contact information
Practice address
214 WISTERIA LN APT 3A, PETERSBURG, VA 23805-9165
(804) 735-3703
Mailing address
214 WISTERIA LN APT 3A, PETERSBURG, VA 23805-9165
(804) 735-3703
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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