Provider Demographics
NPI:1275370710
Name:SAMPSON TRANSPORTATION & DISTRIBUTION PH3 LLC
Entity type:Organization
Organization Name:SAMPSON TRANSPORTATION & DISTRIBUTION PH3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-710-1584
Mailing Address - Street 1:463 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3632
Mailing Address - Country:US
Mailing Address - Phone:434-710-1584
Mailing Address - Fax:
Practice Address - Street 1:300 MONTVUE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5510
Practice Address - Country:US
Practice Address - Phone:434-710-1584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)