Provider Demographics
NPI:1063047843
Name:TRANSPORTATION WITH MO INC
Entity type:Organization
Organization Name:TRANSPORTATION WITH MO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISRTATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-764-0845
Mailing Address - Street 1:PO BOX 852
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371-0852
Mailing Address - Country:US
Mailing Address - Phone:800-764-0845
Mailing Address - Fax:910-745-0705
Practice Address - Street 1:125 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-1609
Practice Address - Country:US
Practice Address - Phone:800-764-0845
Practice Address - Fax:910-745-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle