Provider Demographics
NPI:1386877652
Name:NEED-A-RIDE TRANSPORTATION
Entity type:Organization
Organization Name:NEED-A-RIDE TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLACKMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-784-4627
Mailing Address - Street 1:323 CLIFTON ST
Mailing Address - Street 2:19
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5005
Mailing Address - Country:US
Mailing Address - Phone:252-752-4627
Mailing Address - Fax:252-756-7171
Practice Address - Street 1:323 CLIFTON ST
Practice Address - Street 2:19
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5005
Practice Address - Country:US
Practice Address - Phone:252-752-4627
Practice Address - Fax:252-756-7171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NONE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38049629343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA-00105474Medicaid
NCA00105474Medicaid
NCA-00105474Medicaid
NCA00105474Medicare Oscar/Certification