| NPI | 1801113113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL DENISE MCCLELLAN Owner 336-582-6854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: NC 10454) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-11-17 |