Healthcare Provider Details

I. General information

NPI: 1548043599
Provider Name (Legal Business Name): EXQUISITE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13535 BLACKWATER RD
BAKER LA
70714-6800
US

IV. Provider business mailing address

13535 BLACKWATER RD
BAKER LA
70714-6800
US

V. Phone/Fax

Practice location:
  • Phone: 225-888-6612
  • Fax:
Mailing address:
  • Phone: 225-888-6612
  • 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: CHELSEA PATTERSON
Title or Position: OWNER
Credential:
Phone: 225-888-6612