Healthcare Provider Details

I. General information

NPI: 1730002981
Provider Name (Legal Business Name): PARADISE MED-TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 MORNING GLADE ST
WAKE FOREST NC
27587-3486
US

IV. Provider business mailing address

661 MORNING GLADE ST
WAKE FOREST NC
27587-3486
US

V. Phone/Fax

Practice location:
  • Phone: 585-957-1294
  • Fax:
Mailing address:
  • Phone: 585-957-1294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: DANIEL W-MARIAM
Title or Position: OWNER
Credential:
Phone: 585-957-1294