Provider Demographics
NPI:1013392398
Name:HEALTHY START MEDICAL TRANSPORTATION, INCORPORATED
Entity Type:Organization
Organization Name:HEALTHY START MEDICAL TRANSPORTATION, INCORPORATED
Other - Org Name:HEALTHY START
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LACEMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-949-5541
Mailing Address - Street 1:2501 AIRPORT BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-9673
Mailing Address - Country:US
Mailing Address - Phone:252-678-8894
Mailing Address - Fax:877-698-8894
Practice Address - Street 1:2501 AIRPORT BLVD NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-9673
Practice Address - Country:US
Practice Address - Phone:252-678-8894
Practice Address - Fax:877-698-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NC341600000X, 3416L0300X, 343800000X, 343900000X, 347B00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle