=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477743417
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METROPOLITAN CIRCLES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2007
-----------------------------------------------------
Last Update Date | 07/26/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3510 LINWOOD AVE
-----------------------------------------------------
City | SHREVEPORT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71103-4512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-636-4194
-----------------------------------------------------
Fax | 318-636-4196
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3510 LINWOOD AVE
-----------------------------------------------------
City | SHREVEPORT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71103-4512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-636-4194
-----------------------------------------------------
Fax | 318-636-4196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CO-MANAGER
-----------------------------------------------------
Name | MR. JAMES EDWARD THROWER JR.
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 318-636-4194
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------