Provider Demographics
NPI:1477174365
Name:ROAD RUNNER
Entity type:Organization
Organization Name:ROAD RUNNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAVONE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-702-3239
Mailing Address - Street 1:702B W SAINT JAMES ST
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-4931
Mailing Address - Country:US
Mailing Address - Phone:252-702-3239
Mailing Address - Fax:252-563-5292
Practice Address - Street 1:702B W SAINT JAMES ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-4931
Practice Address - Country:US
Practice Address - Phone:252-702-3239
Practice Address - Fax:252-563-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)