Provider Demographics
NPI:1104196963
Name:PELHAM TRANSPORTATION CORPORATION
Entity Type:Organization
Organization Name:PELHAM TRANSPORTATION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEJOURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-349-7113
Mailing Address - Street 1:114 W MOREHEAD ST
Mailing Address - Street 2:P.O BOX. 664
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-3852
Mailing Address - Country:US
Mailing Address - Phone:336-349-7113
Mailing Address - Fax:336-349-7107
Practice Address - Street 1:114 W MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-3852
Practice Address - Country:US
Practice Address - Phone:336-349-7113
Practice Address - Fax:336-349-7107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC475268343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)