Healthcare Provider Details

I. General information

NPI: 1548767965
Provider Name (Legal Business Name): J&D TRANSIT REGISTERED LLC OF MS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 SPRINGRIDGE RD
CLINTON MS
39056-6528
US

IV. Provider business mailing address

1240 SPRINGRIDGE RD
CLINTON MS
39056-6528
US

V. Phone/Fax

Practice location:
  • Phone: 601-684-8800
  • Fax:
Mailing address:
  • Phone: 601-684-8800
  • 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: LEA JACOBS
Title or Position: GENERAL MANAGER
Credential:
Phone: 601-684-8800