Organization
MACKSUMMBLACK ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLPH ARTHUR MCPHERSON SR. (CHIEF EXECUTIVE OFFECER)
(336) 343-2672
Entity
Organization
Contact information
Practice address
521 ALAMANNI CT, GRAHAM, NC 27253-4472
(336) 343-2672
Mailing address
112 S MARSHALL ST UNIT 1083, GRAHAM, NC 27253-0247
(336) 343-2672
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40409101
—
NC
Enumeration date
01/04/2023
Last updated
01/04/2023
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