Provider Demographics
NPI:1659096568
Name:EXCELLENT TRANSPORTATION SERVICES ENTERPRISES INC
Entity Type:Organization
Organization Name:EXCELLENT TRANSPORTATION SERVICES ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-486-3008
Mailing Address - Street 1:600 WESTPARK CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1754
Mailing Address - Country:US
Mailing Address - Phone:336-486-3008
Mailing Address - Fax:
Practice Address - Street 1:604 WESTPARK CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1754
Practice Address - Country:US
Practice Address - Phone:336-486-3008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)