Healthcare Provider Details

I. General information

NPI: 1558142117
Provider Name (Legal Business Name): PATHWAYS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NC HIGHWAY 305
AULANDER NC
27805-8802
US

IV. Provider business mailing address

PO BOX 789
AULANDER NC
27805-0789
US

V. Phone/Fax

Practice location:
  • Phone: 252-325-2977
  • Fax: 252-345-3732
Mailing address:
  • Phone: 252-325-2977
  • Fax: 252-345-3732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. VANDERBILL CHERRY JR.
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 252-325-2977