Provider Demographics
NPI:1285061556
Name:GOLDSBORO WAYNE TRANSPORTATION AUTHORITY
Entity type:Organization
Organization Name:GOLDSBORO WAYNE TRANSPORTATION AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN, BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-922-9037
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27533-0227
Mailing Address - Country:US
Mailing Address - Phone:919-736-1374
Mailing Address - Fax:919-731-1558
Practice Address - Street 1:600 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3143
Practice Address - Country:US
Practice Address - Phone:919-736-1374
Practice Address - Fax:919-731-1558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)