=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164839080
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAXI - CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2014
-----------------------------------------------------
Last Update Date | 07/14/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1505 BESSON LN
-----------------------------------------------------
City | SUNSHINE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70780
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-227-7419
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P O BOX 444 1505 BESSON LN
-----------------------------------------------------
City | SUNSHINE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70780
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. JOSHUA CRIAG WHITE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 225-227-7419
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------