Provider Demographics
NPI:1124758255
Name:LILYS DEVOTED TRANSPORTATION LLC
Entity type:Organization
Organization Name:LILYS DEVOTED TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-517-2786
Mailing Address - Street 1:570 DICKSON RD
Mailing Address - Street 2:
Mailing Address - City:RIEGELWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28456-8067
Mailing Address - Country:US
Mailing Address - Phone:910-427-3334
Mailing Address - Fax:678-826-0812
Practice Address - Street 1:570 DICKSON RD
Practice Address - Street 2:
Practice Address - City:RIEGELWOOD
Practice Address - State:NC
Practice Address - Zip Code:28456-8067
Practice Address - Country:US
Practice Address - Phone:910-427-3334
Practice Address - Fax:678-826-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)