Provider Demographics
NPI:1487318283
Name:EAGLE MEDICAL TRANS LLC
Entity type:Organization
Organization Name:EAGLE MEDICAL TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:O
Authorized Official - Last Name:UGORJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-523-2453
Mailing Address - Street 1:2121 EISENHOWER AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4688
Mailing Address - Country:US
Mailing Address - Phone:240-252-8521
Mailing Address - Fax:
Practice Address - Street 1:2121 EISENHOWER AVE STE 207
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4688
Practice Address - Country:US
Practice Address - Phone:855-823-2453
Practice Address - Fax:833-552-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance