Healthcare Provider Details

I. General information

NPI: 1124734835
Provider Name (Legal Business Name): TOP GUN TRANSIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 VANCE ST
CLINTON NC
28328-4038
US

IV. Provider business mailing address

3917 PATRIOT RIDGE CT
RALEIGH NC
27610-6459
US

V. Phone/Fax

Practice location:
  • Phone: 984-289-3667
  • Fax:
Mailing address:
  • Phone: 919-780-2137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIC WEST
Title or Position: OWNER
Credential:
Phone: 919-780-2137