Provider Demographics
NPI:1467112805
Name:EXPRESS TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:EXPRESS TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SURRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-849-2925
Mailing Address - Street 1:122 E DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6742
Mailing Address - Country:US
Mailing Address - Phone:803-849-2925
Mailing Address - Fax:
Practice Address - Street 1:122 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6742
Practice Address - Country:US
Practice Address - Phone:803-849-2925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-27
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)