Organization
STATELINE WELLNESS TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD JOSEPH OLIVERO (MANAGER)
(716) 912-7850
Entity
Organization
Contact information
Practice address
23 GATE 11, CAROLINA SHORES, NC 28467-2621
(716) 912-7850
Mailing address
23 GATE 11, CAROLINA SHORES, NC 28467-2621
(716) 912-7850
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
11/12/2021
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