Esubalew Tadesse Amera

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

NPI 1962994616 · NPPES record last updated May 30, 2018

Key facts

NPI
1962994616
Entity type
Individual (NPI type 1)
Primary specialty
Non-emergency Medical Transport (VAN) 343900000X
License
901731 (VA)
Practice address
5403 Robinson LN
Williamsburg, VA 23188-2920
Phone
(757) 272-6331
NPI assigned
May 30, 2018
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
901731VAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsburg Transportation LLC Non-Emergency Medical Transport (Van) Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X 901731 VA
Non-emergency Medical Transport (VAN) 343900000X 901731 VA Yes

Addresses

Primary practice location

5403 Robinson LN
Williamsburg, VA 23188-2920

Mailing address

5403 Robinson LN
Williamsburg, VA 23188-2920
Phone (757) 272-6331

Other providers in Williamsburg, VA

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

Sources for this page

Verify at the official NPI Registry.