Healthcare Provider Details

I. General information

NPI: 1104502715
Provider Name (Legal Business Name): SUREWINGZ TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 FRANKLIN BLVD
GREENSBORO NC
27401
US

IV. Provider business mailing address

210 FRANKLIN BLVD
GREENSBORO NC
27401-4607
US

V. Phone/Fax

Practice location:
  • Phone: 336-340-6872
  • Fax:
Mailing address:
  • Phone: 336-340-6872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JACQUELINE DENISE DAVIS
Title or Position: MANAGER/OWNER
Credential:
Phone: 336-405-7399