Provider Demographics
NPI:1639906845
Name:ONTRAC TRANSPORTATION LLC
Entity type:Organization
Organization Name:ONTRAC TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:YANCEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-257-2801
Mailing Address - Street 1:420 SCIPIO CT
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2942
Mailing Address - Country:US
Mailing Address - Phone:910-257-2801
Mailing Address - Fax:
Practice Address - Street 1:420 SCIPIO CT
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-2942
Practice Address - Country:US
Practice Address - Phone:910-257-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle