Healthcare Provider Details

I. General information

NPI: 1679183222
Provider Name (Legal Business Name): TOUCAN TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2439 MANHATTAN BLVD STE 102-4
HARVEY LA
70058-5473
US

IV. Provider business mailing address

PO BOX 2637
HARVEY LA
70059-2637
US

V. Phone/Fax

Practice location:
  • Phone: 504-261-4976
  • Fax: 504-766-6792
Mailing address:
  • Phone: 504-298-9424
  • Fax: 504-766-6792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL L. JOHNSON III
Title or Position: MANAGER
Credential: CAC, CCGC
Phone: 504-261-4976