Organization
KWIK TRIP LLC
Active
Other names
Fred Jerome Miller
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED JEROME MILLER (OWNER)
(336) 995-1383
Entity
Organization
Contact information
Practice address
1727 WESTCHESTER DR, HIGH POINT, NC 27262-7008
(336) 885-0799
(336) 885-0801
Mailing address
PO BOX 24513, WINSTON SALEM, NC 27114-4513
(336) 995-1383
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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