Provider Demographics
NPI:1164150207
Name:WILMINGTON TRANSPORT
Entity Type:Organization
Organization Name:WILMINGTON TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUDESEAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-297-5752
Mailing Address - Street 1:1290 LIBERTY LANDING RD SE
Mailing Address - Street 2:
Mailing Address - City:WINNABOW
Mailing Address - State:NC
Mailing Address - Zip Code:28479-5144
Mailing Address - Country:US
Mailing Address - Phone:910-777-3900
Mailing Address - Fax:
Practice Address - Street 1:1290 LIBERTY LANDING RD SE
Practice Address - Street 2:
Practice Address - City:WINNABOW
Practice Address - State:NC
Practice Address - Zip Code:28479-5144
Practice Address - Country:US
Practice Address - Phone:910-777-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty