Provider Demographics
NPI:1083484208
Name:MID DEL NON EMERGENCY SHUTTLE LLC
Entity Type:Organization
Organization Name:MID DEL NON EMERGENCY SHUTTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-327-3481
Mailing Address - Street 1:100 SOUTH GARNETT STREET
Mailing Address - Street 2:SUITE # 1001
Mailing Address - City:HENDEERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536
Mailing Address - Country:US
Mailing Address - Phone:877-468-3960
Mailing Address - Fax:
Practice Address - Street 1:810 WARING ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3347
Practice Address - Country:US
Practice Address - Phone:845-327-3481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)