Provider Demographics
NPI:1619384948
Name:TRINITY ONE TRANSPORTATION
Entity Type:Organization
Organization Name:TRINITY ONE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-891-0300
Mailing Address - Street 1:7716 PENCE RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4546
Mailing Address - Country:US
Mailing Address - Phone:980-272-6175
Mailing Address - Fax:
Practice Address - Street 1:7716 PENCE RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4546
Practice Address - Country:US
Practice Address - Phone:980-272-6175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)