Healthcare Provider Details

I. General information

NPI: 1528555760
Provider Name (Legal Business Name): TRAVELING GRACE TRANSPORTATION SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 SHUBRICK STREET
NEW ORLEANS LA
70127
US

IV. Provider business mailing address

7520 SHUBRICK STREET
NEW ORLEANS LA
70127
US

V. Phone/Fax

Practice location:
  • Phone: 504-701-8478
  • Fax: 504-891-1083
Mailing address:
  • Phone: 504-701-8478
  • Fax: 504-891-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3418M1110X
TaxonomyMilitary or U.S. Coast Guard Ground Transport Ambulance
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateLA

VIII. Authorized Official

Name: ANITRA I PIERRE
Title or Position: OWNER/DRIVER
Credential:
Phone: 504-701-8478