Healthcare Provider Details
I. General information
NPI: 1538926225
Provider Name (Legal Business Name): EN ROUTE TRANSIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/29/2024
Last Update Date: 03/09/2024
Certification Date: 03/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1607 ELDER WAY
BURLINGTON NC
27215-6702
US
IV. Provider business mailing address
1607 ELDER WAY
BURLINGTON NC
27215-6702
US
V. Phone/Fax
- Phone: 336-263-5859
- Fax:
- Phone: 336-263-5859
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343800000X |
| Taxonomy | Secured Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LOTOYA
JEFFRIES
POOLE
Title or Position: OWNER
Credential:
Phone: 336-263-5859