Provider Demographics
NPI:1992544605
Name:MCCULLERS DELIVERY SERVICE
Entity type:Organization
Organization Name:MCCULLERS DELIVERY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-438-6019
Mailing Address - Street 1:1030 N ROGERS LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6083
Mailing Address - Country:US
Mailing Address - Phone:919-438-6019
Mailing Address - Fax:
Practice Address - Street 1:520 HINTON OAKS BLVD
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6592
Practice Address - Country:US
Practice Address - Phone:919-438-6019
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)