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General NPI Number Information
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NPI Number | 1548596067
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Entity Type | Organization
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Legal Business Name | MOUNTAIN HIGH TRANSPORTATION GROUP
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 272 GENTRY RD
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City | ERWIN
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State | NC
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Zip | 28339-8637
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Country | US
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Telephone | 267-702-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 227 S LINE ST APT 2
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City | LANSDALE
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State | PA
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Zip | 19446-2528
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Country | US
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Telephone | 267-702-9080
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. KENNETH CHRISTIAN WIMBERLY II
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Credential |
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Telephone | 267-290-7542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 25589944
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License Number State | PA
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