Provider Demographics
NPI:1972363927
Name:QUIET STORM ENTERPRISE LLC
Entity Type:Organization
Organization Name:QUIET STORM ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OVERSEER
Authorized Official - Prefix:
Authorized Official - First Name:TEWANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-263-2292
Mailing Address - Street 1:2904 PRIORESS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-3054
Mailing Address - Country:US
Mailing Address - Phone:910-263-2292
Mailing Address - Fax:
Practice Address - Street 1:2904 PRIORESS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-3054
Practice Address - Country:US
Practice Address - Phone:910-263-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No343800000XTransportation ServicesSecured Medical Transport (VAN)