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General NPI Number Information
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NPI Number | 1639970510
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Entity Type | Organization
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Legal Business Name | ET-AL TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 204 4TH ST
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City | ROBERSONVILLE NC
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State | NC
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Zip | 27871
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Country | US
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Telephone | 919-805-9379
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1582
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City | ROBERSONVILLE
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State | NC
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Zip | 27871-1582
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Country | US
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Telephone | 919-805-9379
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. REGINALD STYLES BAZEMORE JR.
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Credential |
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Telephone | 919-805-9379
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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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