Healthcare Provider Details

I. General information

NPI: 1851209100
Provider Name (Legal Business Name): CHANGE THE SYSTEM TRANSPORT & LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 TENNESSEE ST
BATON ROUGE LA
70802-6755
US

IV. Provider business mailing address

8540 SANTA ROSA AVE
BATON ROUGE LA
70810-6998
US

V. Phone/Fax

Practice location:
  • Phone: 225-650-3369
  • Fax:
Mailing address:
  • Phone: 225-650-3369
  • 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: TYRESE SHAW
Title or Position: CEO
Credential:
Phone: 225-650-3369