Healthcare Provider Details

I. General information

NPI: 1295220960
Provider Name (Legal Business Name): A'S PURPLE PASSION TRANSPORTATION AND SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 JOINER RD
FULTON MS
38843-7427
US

IV. Provider business mailing address

133 JOINER RD
FULTON MS
38843-7427
US

V. Phone/Fax

Practice location:
  • Phone: 662-678-3574
  • Fax:
Mailing address:
  • Phone: 662-678-3574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: APRIL LYNN SHUMPERT
Title or Position: OWNER
Credential:
Phone: 662-231-3833