Provider Demographics
NPI:1285128223
Name:FRANKLIN, BENJAMIN KEVIN
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KEVIN
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3848 MEADOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-2106
Mailing Address - Country:US
Mailing Address - Phone:757-935-7759
Mailing Address - Fax:757-463-3500
Practice Address - Street 1:3848 MEADOWBROOK CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-2106
Practice Address - Country:US
Practice Address - Phone:757-935-7759
Practice Address - Fax:757-463-3500
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA592343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)