Provider Demographics
NPI:1871009555
Name:MOSES TRANSPORTATION LLC
Entity type:Organization
Organization Name:MOSES TRANSPORTATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TASHALY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-977-9706
Mailing Address - Street 1:146 WILEY PL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2473
Mailing Address - Country:US
Mailing Address - Phone:757-977-9706
Mailing Address - Fax:757-463-1860
Practice Address - Street 1:146 WILEY PL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2473
Practice Address - Country:US
Practice Address - Phone:757-977-9707
Practice Address - Fax:757-463-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)