Healthcare Provider Details

I. General information

NPI: 1275197907
Provider Name (Legal Business Name): ANDERSON BROTHERS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 CASCIO RD
MOSS BLUFF LA
70611-6018
US

IV. Provider business mailing address

739 CASCIO RD
MOSS BLUFF LA
70611-6018
US

V. Phone/Fax

Practice location:
  • Phone: 337-853-8580
  • Fax: 337-409-0431
Mailing address:
  • Phone: 337-853-8580
  • Fax: 337-409-0431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. HAROLD ANDERSON JR.
Title or Position: OWNER
Credential:
Phone: 337-853-8580