Provider Demographics
NPI:1942876826
Name:STAY PAWSOME
Entity Type:Organization
Organization Name:STAY PAWSOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-264-1410
Mailing Address - Street 1:7151 OKELLY CHAPEL RD # 143
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6849
Mailing Address - Country:US
Mailing Address - Phone:919-264-1410
Mailing Address - Fax:
Practice Address - Street 1:30000 FOLKLORE WAY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6849
Practice Address - Country:US
Practice Address - Phone:919-264-1410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAY PAWSOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-01
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)