Healthcare Provider Details

I. General information

NPI: 1275468910
Provider Name (Legal Business Name): FANTASTIC 7 TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 SECTION AVE
RAYNE LA
70578-6125
US

IV. Provider business mailing address

905 SECTION AVE
RAYNE LA
70578-6125
US

V. Phone/Fax

Practice location:
  • Phone: 318-754-8538
  • Fax:
Mailing address:
  • Phone: 318-754-8538
  • Fax:

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: ROBIN WALKER
Title or Position: OWNER
Credential:
Phone: 318-754-8538