Provider Demographics
NPI:1093559379
Name:DIGNIFIED TRANSPORT SERVICE LLC
Entity type:Organization
Organization Name:DIGNIFIED TRANSPORT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REVA
Authorized Official - Middle Name:
Authorized Official - Last Name:OTEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-616-0348
Mailing Address - Street 1:4964 THORNSPRING RD
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-7022
Mailing Address - Country:US
Mailing Address - Phone:540-616-0348
Mailing Address - Fax:540-994-9598
Practice Address - Street 1:4964 THORNSPRING RD
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-7022
Practice Address - Country:US
Practice Address - Phone:540-616-0348
Practice Address - Fax:540-994-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)