Healthcare Provider Details
I. General information
NPI: 1477060044
Provider Name (Legal Business Name): HOARD MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2513 MARTIN DR
WINNSBORO LA
71295-3411
US
IV. Provider business mailing address
2513 MARTIN DR
WINNSBORO LA
71295-3411
US
V. Phone/Fax
- Phone: 318-801-3128
- Fax: 318-367-5124
- Phone: 318-801-3128
- Fax: 318-367-5124
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DESI
DESMOND
HOARD
Title or Position: OWNER
Credential:
Phone: 318-801-3128