Provider Demographics
NPI:1053155192
Name:BUCKNER LTD CO
Entity type:Organization
Organization Name:BUCKNER LTD CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-998-7665
Mailing Address - Street 1:1235 EAST BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5876
Mailing Address - Country:US
Mailing Address - Phone:803-998-7665
Mailing Address - Fax:
Practice Address - Street 1:1235 EAST BLVD STE E
Practice Address - Street 2:SUITE E #339
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5876
Practice Address - Country:US
Practice Address - Phone:803-998-7665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)