Provider Demographics
NPI:1477768976
Name:MCCLOUD INC.
Entity Type:Organization
Organization Name:MCCLOUD INC.
Other - Org Name:THE OLE HOMEPLACE TRANSPORT INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-221-3456
Mailing Address - Street 1:3310 HOLMES BEND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-8403
Mailing Address - Country:US
Mailing Address - Phone:270-384-0560
Mailing Address - Fax:270-384-0560
Practice Address - Street 1:3310 HOLMES BEND RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-8403
Practice Address - Country:US
Practice Address - Phone:270-384-0560
Practice Address - Fax:270-384-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43000231Medicaid