Provider Demographics
NPI:1669520086
Name:HUMANA WHEELCHAIR TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:HUMANA WHEELCHAIR TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANDREWS
Authorized Official - Last Name:UMANAH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:704-536-8332
Mailing Address - Street 1:3540 NEVINBROOK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3900
Mailing Address - Country:US
Mailing Address - Phone:704-509-5527
Mailing Address - Fax:704-509-5527
Practice Address - Street 1:3555 N SHARON AMITY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-8935
Practice Address - Country:US
Practice Address - Phone:704-536-8332
Practice Address - Fax:704-509-5527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145880343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)