Healthcare Provider Details

I. General information

NPI: 1356287395
Provider Name (Legal Business Name): RICHMOND COUNTY COALITION FOR JUSTICE AND BLACK EMPOWERMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 US HIGHWAY 1 S
ROCKINGHAM NC
28379-8987
US

IV. Provider business mailing address

PO BOX 272
ROCKINGHAM NC
28380-0272
US

V. Phone/Fax

Practice location:
  • Phone: 472-265-4350
  • Fax:
Mailing address:
  • Phone: 472-265-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: SHAUN GRADY INGRAM
Title or Position: OWNER/MANAGER
Credential:
Phone: 472-265-4350