Provider Demographics
NPI:1194416776
Name:COOK, ORLANDO
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0123
Mailing Address - Country:US
Mailing Address - Phone:980-866-2005
Mailing Address - Fax:980-217-0007
Practice Address - Street 1:720 YVONNE DR SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-3914
Practice Address - Country:US
Practice Address - Phone:980-866-2005
Practice Address - Fax:980-217-0007
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)