Healthcare Provider Details

I. General information

NPI: 1992417653
Provider Name (Legal Business Name): RESOURCEFUL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5412 CENTRAL AVE STE A
CHARLOTTE NC
28212-2706
US

IV. Provider business mailing address

5412 CENTRAL AVE STE A
CHARLOTTE NC
28212-2706
US

V. Phone/Fax

Practice location:
  • Phone: 704-503-9961
  • Fax:
Mailing address:
  • Phone: 704-503-9961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE L TYSON
Title or Position: MANAGING MEMBER
Credential:
Phone: 980-213-5501