=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003521279
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEA HELPERS TRANSPORTATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2023
-----------------------------------------------------
Last Update Date | 06/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 77 SLADE CT
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27315-9325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-465-7156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 77 SLADE CT
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27315-9325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-465-7156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMPLOYER
-----------------------------------------------------
Name | MRS. CHEYENNE LEA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 251-465-7156
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------