Healthcare Provider Details

I. General information

NPI: 1801113113
Provider Name (Legal Business Name): GROMEDS TO GO TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8025 N POINT BLVD STE 105
WINSTON SALEM NC
27106-3752
US

IV. Provider business mailing address

8025 N POINT BLVD STE 105
WINSTON SALEM NC
27106-3752
US

V. Phone/Fax

Practice location:
  • Phone: 336-553-6503
  • Fax: 336-218-6829
Mailing address:
  • Phone: 336-553-6503
  • Fax: 336-218-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number10454
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CAROL DENISE MCCLELLAN
Title or Position: OWNER
Credential: CEO
Phone: 336-582-6854