Healthcare Provider Details

I. General information

NPI: 1689118648
Provider Name (Legal Business Name): T & L TRANSPORTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2016
Last Update Date: 12/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5327 CARNELIAN DR
RALEIGH NC
27610-2572
US

IV. Provider business mailing address

5327 CARNELIAN DR
RALEIGH NC
27610-2572
US

V. Phone/Fax

Practice location:
  • Phone: 919-799-6008
  • Fax:
Mailing address:
  • Phone: 919-799-6008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TRAVAE MARQUES WILLIS
Title or Position: CEO/OWNER
Credential:
Phone: 919-799-6008