MEDICARE: KAZIST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	344600000X	Taxi	LA
2	347E00000X	Transportation Broker	LA
3	261QR1100X	Research Clinic/Center	LA
4	343900000X	Non-emergency Medical Transport (VAN)	LA

General Provider Information

NPI Number	:	1598288862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAZIST LLC

Provider Business Mailing Address
First Line	:	392 MANSFIELD DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-7318
Country	:	US
Telephone Number	:	504-481-6452
Fax Number	:	985-605-7228

Provider Business Practice Location Address
First Line	:	2138 SELMA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-4040
Country	:	US
Telephone Number	:	504-481-6652
Fax Number	:	985-605-7228

Authorized Official
Title or Position	:	MANAGER
Name	:	NYEKAZI GREEN
Credential	:
Telephone Number	:	504-481-6652

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	07/21/2022

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Directions to “KAZIST LLC ” Practice Location

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