Healthcare Provider Details

I. General information

NPI: 1992209043
Provider Name (Legal Business Name): SHYNE BRIGHT VAN TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 E PINE ST
AMITE LA
70422-2824
US

IV. Provider business mailing address

116 E PINE ST
AMITE LA
70422-2824
US

V. Phone/Fax

Practice location:
  • Phone: 504-300-3544
  • Fax: 504-246-8510
Mailing address:
  • Phone: 504-300-3544
  • Fax: 504-246-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITTANY REED
Title or Position: OWNER
Credential:
Phone: 504-300-3544