Healthcare Provider Details

I. General information

NPI: 1871765495
Provider Name (Legal Business Name): KEENAN'S TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62390 JOHN SMITH RD
PEARL RIVER LA
70452
US

IV. Provider business mailing address

62390 JOHN SMITH RD
PEARL RIVER LA
70452
US

V. Phone/Fax

Practice location:
  • Phone: 985-863-3212
  • Fax: 985-863-7999
Mailing address:
  • Phone: 985-863-3212
  • Fax: 985-863-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number94083316
License Number StateLA

VIII. Authorized Official

Name: MR. THOMAS J SMITH JR.
Title or Position: MANAGER
Credential:
Phone: 985-863-3212