Healthcare Provider Details

I. General information

NPI: 1437426210
Provider Name (Legal Business Name): CDC TRANSPORTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E ASKEW ST
TALLULAH LA
71282-3706
US

IV. Provider business mailing address

PO BOX 7563
MONROE LA
71211-7563
US

V. Phone/Fax

Practice location:
  • Phone: 318-574-1232
  • Fax:
Mailing address:
  • Phone:
  • 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: ADRIAN FISHER
Title or Position: PRESIDENT
Credential:
Phone: 318-614-7644