Healthcare Provider Details

I. General information

NPI: 1588407936
Provider Name (Legal Business Name): T & C COMMUNITY TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 N MAIN ST
TARBORO NC
27886-2135
US

IV. Provider business mailing address

4644 MCNAIR RD
TARBORO NC
27886-8738
US

V. Phone/Fax

Practice location:
  • Phone: 252-823-0690
  • Fax: 252-824-7772
Mailing address:
  • Phone: 252-823-0690
  • Fax: 252-824-7772

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
# 3
Primary TaxonomyN
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: CRYSTAL WORSLEY
Title or Position: OWNER
Credential:
Phone: 252-823-0690