Healthcare Provider Details

I. General information

NPI: 1063316966
Provider Name (Legal Business Name): SUPREME DASH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2543 VERBENA ST
NEW ORLEANS LA
70122-4863
US

IV. Provider business mailing address

2543 VERBENA ST
NEW ORLEANS LA
70122-4863
US

V. Phone/Fax

Practice location:
  • Phone: 504-439-9369
  • Fax:
Mailing address:
  • Phone: 504-439-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANTONIO CRAWFORD
Title or Position: CO-OWNER
Credential:
Phone: 504-439-9369