Forris IV Care Transportation LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

FORRIS IV CARE TRANSPORTATION LLC

Practice address

4189 Dale Dr
Farmville, NC 27828-1217

Phone

(252) 702-8651

NPI assigned

Aug 16, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Forris Lacoste Fulford III

Title

Owner

Phone

(252) 702-8651

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1215769450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4189 DALE DR",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281217",
            "telephone_number": "252-702-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4189 DALE DR",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281217",
            "telephone_number": "252-702-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORRIS IV CARE TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "FULFORD",
        "authorized_official_first_name": "FORRIS",
        "authorized_official_middle_name": "LACOSTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-702-8651",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Farmville, NC
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• Private Vehicle in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.