Provider Demographics
NPI:1114465127
Name:GLEE, HOWARD DARNELL JR
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:DARNELL
Last Name:GLEE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GUM NECK POST OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NC
Mailing Address - Zip Code:27925-9578
Mailing Address - Country:US
Mailing Address - Phone:252-394-6011
Mailing Address - Fax:
Practice Address - Street 1:600 GUM NECK POST OFFICE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NC
Practice Address - Zip Code:27925-9578
Practice Address - Country:US
Practice Address - Phone:252-394-6011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 343900000X
NCPEH2390347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)