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General NPI Number Information
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NPI Number | 1417675422
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Entity Type | Organization
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Legal Business Name | LOCUST TRANSPORT LLC
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 2308 UNIONVILLE INDIAN TRAIL RD W
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-6757
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Country | US
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Telephone | 704-267-0367
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Fax |
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Provider Business Mailing Address
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Address Line | 2308 UNIONVILLE INDIAN TRAIL RD W
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-6757
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Country | US
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Telephone | 704-267-0367
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | KATINA LIVINGSTON
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Credential |
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Telephone | 704-267-0367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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