| NPI | 1992178586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIBA BROGDON CFO 704-701-0836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: SC 000000000) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: SC 000000001) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |