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General NPI Number Information
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NPI Number | 1568157634
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA TRANSPORTATION LLC
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 603 MCKINLEY AVE
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City | GREENVILLE
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State | NC
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Zip | 27834-3035
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Country | US
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Telephone | 252-412-6502
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 N WAVERLY ST
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City | FARMVILLE
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State | NC
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Zip | 27828-1473
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Country | US
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Telephone | 631-464-6346
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Fax |
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Authorized Official
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Title or Position | PARA PROFESSIONAL
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Name | MR. JOHN LEE BUCKMON JR.
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Credential | PP , PSS
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Telephone | 347-633-8460
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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 |
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License Number State |
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