Healthcare Provider Details
I. General information
NPI: 1457633992
Provider Name (Legal Business Name): BAILEYS EXPRESS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2011
Last Update Date: 09/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 NORMANDIE LN
MINDEN LA
71055-7437
US
IV. Provider business mailing address
250 NORMANDIE LN
MINDEN LA
71055-7437
US
V. Phone/Fax
- Phone: 318-268-8077
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | 007067216 |
| License Number State | LA |
VIII. Authorized Official
Name:
KENDRICK
BAILEY
Title or Position: MANAGER
Credential:
Phone: 318-268-8077