Healthcare Provider Details

I. General information

NPI: 1467088237
Provider Name (Legal Business Name): PEACEFUL TRANSPORTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 TOULINE ST
NATCHITOCHES LA
71457-4639
US

IV. Provider business mailing address

PO BOX 29372
SHREVEPORT LA
71149-9372
US

V. Phone/Fax

Practice location:
  • Phone: 318-379-4751
  • Fax: 310-300-3772
Mailing address:
  • Phone: 318-379-4751
  • Fax: 318-300-3772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT TERRY
Title or Position: MEMBER
Credential: M.A.
Phone: 318-379-4751