Provider Demographics
NPI:1982267092
Name:TARHEELBLUETRANSPORTATION LLC
Entity Type:Organization
Organization Name:TARHEELBLUETRANSPORTATION LLC
Other - Org Name:TARHEEL BLUE TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHABAZZ
Authorized Official - Middle Name:JAMA
Authorized Official - Last Name:CHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-512-3381
Mailing Address - Street 1:7 ELSWORTH CT
Mailing Address - Street 2:
Mailing Address - City:MCLEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301
Mailing Address - Country:US
Mailing Address - Phone:336-512-3381
Mailing Address - Fax:
Practice Address - Street 1:7 ELSWORTH CT
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9308
Practice Address - Country:US
Practice Address - Phone:336-512-3381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Multi-Specialty
No344600000XTransportation ServicesTaxi