1518524750 NPI number — HOME RUN TRANSPORTATION & SERVICES, LLC

Table of content: DR. ERNEST GARY JEFFORDS DMD (NPI 1306986369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518524750 NPI number — HOME RUN TRANSPORTATION & SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME RUN TRANSPORTATION & SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518524750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOTSYLVANIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22553-6811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-734-9423
Provider Business Mailing Address Fax Number:
202-951-4217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12600 HERITAGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22407-2143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-734-9423
Provider Business Practice Location Address Fax Number:
202-951-4217
Provider Enumeration Date:
05/23/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ABRAMS
Authorized Official First Name:
MARTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
540-734-9423

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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