=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427911080
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREENVILLE TRANSPORTATION SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2025
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1521 MANCHESTER DR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-6650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-565-6809
-----------------------------------------------------
Fax | 252-565-6809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1521 MANCHESTER DR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-6650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-565-6809
-----------------------------------------------------
Fax | 252-565-6809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | MR. DEREK JUAN GRAVES JR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-565-6809
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------