Provider Demographics
NPI:1871983767
Name:SOUTHERN COMFORT RIDES, LLC
Entity type:Organization
Organization Name:SOUTHERN COMFORT RIDES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-934-2425
Mailing Address - Street 1:2563 CORNWALLIS RD
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8018
Mailing Address - Country:US
Mailing Address - Phone:919-934-2425
Mailing Address - Fax:
Practice Address - Street 1:2563 CORNWALLIS RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8018
Practice Address - Country:US
Practice Address - Phone:919-934-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3418M1120XTransportation ServicesMilitary/U.S. Coast Guard TransportMilitary or U.S. Coast Guard Ambulance, Air Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)