Provider Demographics
NPI:1699514208
Name:GLOVER TRANSPORT LLC
Entity type:Organization
Organization Name:GLOVER TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:910-214-2076
Mailing Address - Street 1:65 BASSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-9303
Mailing Address - Country:US
Mailing Address - Phone:910-214-2076
Mailing Address - Fax:
Practice Address - Street 1:65 BASSTOWN RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-9303
Practice Address - Country:US
Practice Address - Phone:910-214-2076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)