Provider Demographics
NPI:1316788433
Name:CHAIRCARE TRANSPORT LLC
Entity type:Organization
Organization Name:CHAIRCARE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHENER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:919-628-8817
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27528-0387
Mailing Address - Country:US
Mailing Address - Phone:919-628-8817
Mailing Address - Fax:
Practice Address - Street 1:11190 RALEIGH RD
Practice Address - Street 2:
Practice Address - City:FOUR OAKS
Practice Address - State:NC
Practice Address - Zip Code:27524-7351
Practice Address - Country:US
Practice Address - Phone:919-628-8817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)