Iesha Boulware

Individual provider Active NPI Non-emergency Medical Transport (VAN) · Lorton, VA

NPI 1174368658 · NPPES record last updated Jun 27, 2024

Key facts

NPI
1174368658
Entity type
Individual (NPI type 1)
Primary specialty
Non-emergency Medical Transport (VAN) 343900000X
Practice address
9414 Lakeland Fells LN
Lorton, VA 22079-5016
Phone
(703) 371-7456
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
A-List Medical Transportation LLC Non-Emergency Medical Transport (Van) Current
since Sep 23, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Yes

Addresses

Primary practice location

9414 Lakeland Fells LN
Lorton, VA 22079-5016

Mailing address

9414 Lakeland Fells LN
Lorton, VA 22079-5016
Phone (703) 371-7456

Other providers in Lorton, VA

All providers in Lorton, VA · Non-emergency Medical Transport (VAN) in Virginia

Sources for this page

Verify at the official NPI Registry.