Provider Demographics
NPI:1316263999
Name:THE OLE HOMEPLACE TRANSPORT INC.
Entity type:Organization
Organization Name:THE OLE HOMEPLACE TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-384-0148
Mailing Address - Street 1:113 CAMPBELLSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-1434
Mailing Address - Country:US
Mailing Address - Phone:270-384-0148
Mailing Address - Fax:
Practice Address - Street 1:113 CAMPBELLSVILLE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1434
Practice Address - Country:US
Practice Address - Phone:270-384-0148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3569343800000X, 347C00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle