Tricare Medical Transportation Service LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

TRICARE MEDICAL TRANSPORTATION SERVICE LLC

Practice address

214 Wisteria LN Apt 3a
Petersburg, VA 23805-9165

Phone

(804) 735-3703

NPI assigned

Dec 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Simone D King

Title

Owner/Ceo

Phone

(804) 735-3703

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545350400000",
    "number": "1871065326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 WISTERIA LN APT 3A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059165",
            "telephone_number": "804-735-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WISTERIA LN APT 3A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059165",
            "telephone_number": "804-735-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE MEDICAL TRANSPORTATION SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2018-12-21",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "804-735-3703",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.