Provider Demographics
NPI:1417782103
Name:WAYMAKER TRANSPORTATION LLC
Entity type:Organization
Organization Name:WAYMAKER TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LEONNA
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:910-736-6865
Mailing Address - Street 1:13001 US HIGHWAY 74 W
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-9554
Mailing Address - Country:US
Mailing Address - Phone:910-736-6865
Mailing Address - Fax:
Practice Address - Street 1:2451 NC HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-4293
Practice Address - Country:US
Practice Address - Phone:910-736-6865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)