Healthcare Provider Details

I. General information

NPI: 1639675861
Provider Name (Legal Business Name): PAYNE MAYS ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 4TH ST # 421
BERNICE LA
71222-4014
US

IV. Provider business mailing address

PO BOX 565
BERNICE LA
71222-0565
US

V. Phone/Fax

Practice location:
  • Phone: 318-285-0101
  • Fax: 318-285-0102
Mailing address:
  • Phone: 318-285-0101
  • Fax: 318-285-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSIA PAYNE MAYS
Title or Position: PRESIDENT
Credential: RN
Phone: 213-880-7872