Healthcare Provider Details

I. General information

NPI: 1235753005
Provider Name (Legal Business Name): JAMIE D BONDS NEMT PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2020
Last Update Date: 06/07/2020
Certification Date: 06/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11168 REGENCY AVE
HAMMOND LA
70403-2605
US

IV. Provider business mailing address

11168 REGENCY AVE
HAMMOND LA
70403-2605
US

V. Phone/Fax

Practice location:
  • Phone: 985-474-5668
  • Fax:
Mailing address:
  • Phone: 985-474-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number010793176
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number010793176
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: