Provider Demographics
NPI:1306080056
Name:CHARITY III TRANSPORTATION
Entity type:Organization
Organization Name:CHARITY III TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-910-1929
Mailing Address - Street 1:PO BOX 8057
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-8057
Mailing Address - Country:US
Mailing Address - Phone:301-910-1929
Mailing Address - Fax:240-396-4144
Practice Address - Street 1:3407 NAVY DAY DR
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2120
Practice Address - Country:US
Practice Address - Phone:202-320-4728
Practice Address - Fax:240-396-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-25
Last Update Date:2009-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL12988390343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)