Provider Demographics
NPI:1710703764
Name:BIG RIVER TRANSPORT LLC
Entity type:Organization
Organization Name:BIG RIVER TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EADS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-599-2521
Mailing Address - Street 1:123 IVY DR
Mailing Address - Street 2:
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-2123
Mailing Address - Country:US
Mailing Address - Phone:540-599-2521
Mailing Address - Fax:
Practice Address - Street 1:123 IVY DR
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-2123
Practice Address - Country:US
Practice Address - Phone:540-599-2521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)