Provider Demographics
NPI:1568714434
Name:GOLDEN EAGLE TAXI CORPORATION
Entity Type:Organization
Organization Name:GOLDEN EAGLE TAXI CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-669-2773
Mailing Address - Street 1:1606 E WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-7414
Mailing Address - Country:US
Mailing Address - Phone:336-227-0550
Mailing Address - Fax:336-227-8898
Practice Address - Street 1:1606 E WEBB AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-7414
Practice Address - Country:US
Practice Address - Phone:336-227-0550
Practice Address - Fax:336-227-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4977751344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi