Healthcare Provider Details

I. General information

NPI: 1487432159
Provider Name (Legal Business Name): L&LC RELIABLE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 FAIRFIELD PL
VALDOSTA GA
31602-2563
US

IV. Provider business mailing address

2217 FAIRFIELD PL
VALDOSTA GA
31602-2563
US

V. Phone/Fax

Practice location:
  • Phone: 863-223-9655
  • Fax:
Mailing address:
  • Phone: 863-223-9655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA Y CALLAWAY
Title or Position: CEO
Credential:
Phone: 863-223-9655