Provider Demographics
NPI:1700122108
Name:MITCHELL COUNTY TRANSPORTATION AUTHORITY
Entity Type:Organization
Organization Name:MITCHELL COUNTY TRANSPORTATION AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLALOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-688-4715
Mailing Address - Street 1:73 CRIMSON LAUREL CIRCLE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705
Mailing Address - Country:US
Mailing Address - Phone:828-688-4715
Mailing Address - Fax:828-688-3510
Practice Address - Street 1:73 CRIMSON LAUREL CIRCLE
Practice Address - Street 2:SUITE 7
Practice Address - City:BAKERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28705
Practice Address - Country:US
Practice Address - Phone:828-688-4715
Practice Address - Fax:828-688-3510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITCHELL COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)