=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174381966
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART OF NC TRANSPORTATION INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2024
-----------------------------------------------------
Last Update Date | 03/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 S FAYETTEVILLE ST STE 203-F
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-5871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-662-2436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 S FAYETTEVILLE ST STE 203-F
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-5871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-662-2436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MISTY C CASSADY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-662-2436
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------