Healthcare Provider Details

I. General information

NPI: 1174194468
Provider Name (Legal Business Name): BRYANT TRANSPORTATION HALO TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 GAGE LN
WASHINGTON NC
27889-8000
US

IV. Provider business mailing address

20 GAGE LN
WASHINGTON NC
27889-8000
US

V. Phone/Fax

Practice location:
  • Phone: 919-810-1038
  • Fax:
Mailing address:
  • Phone: 252-402-0226
  • 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 Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: TISHA LASHAWN BIGGS
Title or Position: OWNER
Credential:
Phone: 252-402-0226