Provider Demographics
NPI:1245854736
Name:RDU MEDICAL TRANSPORTATION GROUP
Entity type:Organization
Organization Name:RDU MEDICAL TRANSPORTATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKECIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JONES WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MRS
Authorized Official - Phone:919-799-6008
Mailing Address - Street 1:3751 JUNCTION BLVD SUITE C RALEIGH NC 27603
Mailing Address - Street 2:C
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603
Mailing Address - Country:US
Mailing Address - Phone:919-799-6008
Mailing Address - Fax:
Practice Address - Street 1:3751 JUNCTION BLVD SUITE C RALEIGH NC 27603
Practice Address - Street 2:C
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603
Practice Address - Country:US
Practice Address - Phone:919-799-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)