Provider Demographics
NPI:1730796798
Name:MAP TRANSPORT LLC
Entity type:Organization
Organization Name:MAP TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-224-4696
Mailing Address - Street 1:1570 JARRETT DR
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-4914
Mailing Address - Country:US
Mailing Address - Phone:276-224-4696
Mailing Address - Fax:
Practice Address - Street 1:121 S ELM ST STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2791
Practice Address - Country:US
Practice Address - Phone:276-224-4696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)