Dexmar Transportation Service LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

EEV7605 Issued in NC

Legal business name

DEXMAR TRANSPORTATION SERVICE LLC

Practice address

9235 US Highway 158
Stokesdale, NC 27357-9258

Phone

(336) 298-4225

Fax

(336) 298-4225

NPI assigned

Sep 12, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Dexter Russom

Title

Owner

Phone

(336) 298-4225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1508314204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9235 US HIGHWAY 158",
            "city": "STOKESDALE",
            "state": "NC",
            "postal_code": "273579258",
            "telephone_number": "336-298-4225",
            "fax_number": "336-298-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9235 US HIGHWAY 158",
            "city": "STOKESDALE",
            "state": "NC",
            "postal_code": "273579258",
            "telephone_number": "336-298-4225",
            "fax_number": "336-298-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXMAR TRANSPORTATION SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "RUSSOM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DEXTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-298-4225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NC",
            "license": "EEV7605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Stokesdale, NC
• Providers in Stokesdale, NC by specialty
• Non-emergency Medical Transport (VAN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.