MEDICARE: COMPANIONS II OF NORTH CAROLINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1942027065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPANIONS II OF NORTH CAROLINA

Provider Business Mailing Address
First Line	:	109 HAY ST STE 202
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-6107
Country	:	US
Telephone Number	:	910-974-8403
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 HAY ST STE 202
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-6107
Country	:	US
Telephone Number	:	910-974-8403
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TOWANAKA YVETTE BASS
Credential	:
Telephone Number	:	910-974-8403

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	09/20/2024

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