Healthcare Provider Details

I. General information

NPI: 1821953530
Provider Name (Legal Business Name): MANGO TRANSPORTATION & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 CAVALIER LN
ROCK HILL SC
29730-3452
US

IV. Provider business mailing address

1056 CAVALIER LN
ROCK HILL SC
29730-3452
US

V. Phone/Fax

Practice location:
  • Phone: 704-475-3835
  • Fax:
Mailing address:
  • Phone: 704-475-3835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHANNAN BRYANT
Title or Position: FOUNDER/COO
Credential:
Phone: 704-475-3835