Provider Demographics
NPI:1962869271
Name:CAPE FEAR REGIONAL TRANSPORT INC
Entity type:Organization
Organization Name:CAPE FEAR REGIONAL TRANSPORT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-907-8063
Mailing Address - Street 1:609 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-7759
Mailing Address - Country:US
Mailing Address - Phone:336-677-1116
Mailing Address - Fax:
Practice Address - Street 1:609 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7759
Practice Address - Country:US
Practice Address - Phone:336-677-1116
Practice Address - Fax:336-677-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1962869271Medicaid