=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457203671
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MELANATED HEALTH LOGISTICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1363 DREXEL PL
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28209-2537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-690-9046
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1363 DREXEL PL
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28209-2537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-690-9046
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JACQUELINE DENISE BOYD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 980-785-8892
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------