Provider Demographics
NPI:1083463251
Name:HEALINGLAND MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:HEALINGLAND MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:BIRUKTAWIT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-337-2809
Mailing Address - Street 1:7217 LOCKPORT PL STE 104
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1596
Mailing Address - Country:US
Mailing Address - Phone:703-337-2809
Mailing Address - Fax:
Practice Address - Street 1:7217 LOCKPORT PL STE 104
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1596
Practice Address - Country:US
Practice Address - Phone:703-337-2809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALINGLAND HEALTHCARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-18
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)