Organization
MEDICAID TRAVEL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DYLAN MACK CARDEN (CEO)
(919) 737-0734
Entity
Organization
Contact information
Practice address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(919) 737-0734
(216) 250-8369
Mailing address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(919) 737-0734
(216) 250-8369
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
12/30/2019
Last updated
06/25/2020
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