Healthcare Provider Details
I. General information
NPI: 1134799455
Provider Name (Legal Business Name): AA & Q TRANSPORTATION INC,
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2021
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4919 ALBEMARLE RD STE 105
CHARLOTTE NC
28205-6653
US
IV. Provider business mailing address
4919 ALBEMARLE RD STE 105
CHARLOTTE NC
28205-6653
US
V. Phone/Fax
- Phone: 980-447-3070
- Fax: 704-448-2050
- Phone: 980-447-3070
- Fax: 704-448-2050
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172A00000X |
| Taxonomy | Driver |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAMIYAL
SHAVONDAR
CHAMBERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: TRANSPORTATION PROVI
Phone: 980-447-3070