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General NPI Number Information
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NPI Number | 1154197549
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Entity Type | Organization
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Legal Business Name | PINEY WOODS FIRST CLASS TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 1007 VAN BUREN DR
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City | JONESBORO
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State | LA
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Zip | 71251-2221
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Country | US
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Telephone | 318-564-6310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1122
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City | HODGE
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State | LA
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Zip | 71247-1122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JONATHON DIAS
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Credential |
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Telephone | 318-564-6310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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