Organization
IMPACT SPECIALIZED TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY WAYNE SWAN (CEO)
(704) 707-5311
Entity
Organization
Contact information
Practice address
1646 EASTWOOD DR, KANNAPOLIS, NC 28083-6028
(704) 707-5311
Mailing address
1646 EASTWOOD DR, KANNAPOLIS, NC 28083-6028
(704) 707-5311
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
22469655
WV
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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