Healthcare Provider Details

I. General information

NPI: 1386517134
Provider Name (Legal Business Name): ROBIN HURT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2025
Last Update Date: 10/24/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 SANDY RIDGE CHURCH RD
ELLERBE NC
28338-9170
US

IV. Provider business mailing address

561 SANDY RIDGE CHURCH RD
ELLERBE NC
28338-9170
US

V. Phone/Fax

Practice location:
  • Phone: 937-309-9537
  • Fax:
Mailing address:
  • Phone: 937-309-9537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number000047149826
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: