Provider Demographics
NPI:1245780899
Name:WHITE GLOVE TRANSPORTATION, INC
Entity Type:Organization
Organization Name:WHITE GLOVE TRANSPORTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-424-4516
Mailing Address - Street 1:PO BOX 12821
Mailing Address - Street 2:
Mailing Address - City:RTP
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2821
Mailing Address - Country:US
Mailing Address - Phone:919-424-4516
Mailing Address - Fax:
Practice Address - Street 1:4845 INDUSTRY LN
Practice Address - Street 2:SUITE A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1974
Practice Address - Country:US
Practice Address - Phone:919-424-4516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle