Healthcare Provider Details

I. General information

NPI: 1326618471
Provider Name (Legal Business Name): LIFETIME CARE SHUTTLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 DOVE CT
ROCKY MOUNT NC
27804-6142
US

IV. Provider business mailing address

2325 DOVE CT
ROCKY MOUNT NC
27804-6142
US

V. Phone/Fax

Practice location:
  • Phone: 252-452-4346
  • Fax:
Mailing address:
  • Phone: 252-452-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: TINA WEST
Title or Position: OWNER
Credential:
Phone: 252-452-4346