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General NPI Number Information
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NPI Number | 1093648073
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Entity Type | Organization
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Legal Business Name | MED ONE TRANSPORT LLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 2924 KNIGHT ST STE 340
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City | SHREVEPORT
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State | LA
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Zip | 71105-2413
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Country | US
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Telephone | 318-603-3184
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Fax |
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Provider Business Mailing Address
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Address Line | 2924 KNIGHT ST STE 340
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City | SHREVEPORT
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State | LA
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Zip | 71105-2413
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Country | US
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Telephone | 318-603-3184
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRODRICK WELLS
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Credential |
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Telephone | 318-658-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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