Healthcare Provider Details

I. General information

NPI: 1336875913
Provider Name (Legal Business Name): STEADY MED TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W 4TH ST UNIT 318
CHARLOTTE NC
28202-1545
US

IV. Provider business mailing address

525 S CHURCH ST APT 1905
CHARLOTTE NC
28202-3321
US

V. Phone/Fax

Practice location:
  • Phone: 704-412-4016
  • Fax:
Mailing address:
  • Phone: 305-744-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LISA WILKINSON
Title or Position: DEPUTY DIRECTOR
Credential: LMFT
Phone: 305-744-5770