Provider Demographics
NPI:1598554875
Name:PURPLE SQUIRREL LLC
Entity type:Organization
Organization Name:PURPLE SQUIRREL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VELDOSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-459-5300
Mailing Address - Street 1:236 MARKET ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9439
Mailing Address - Country:US
Mailing Address - Phone:704-459-5300
Mailing Address - Fax:704-703-6197
Practice Address - Street 1:234 ELLA DR
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-9642
Practice Address - Country:US
Practice Address - Phone:704-459-5300
Practice Address - Fax:704-703-6197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-03
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle