| NPI | 1033669684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERVENT DACOSTA Owner 571-589-6509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343800000X Secured Medical Transport (VAN) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |