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General NPI Number Information
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NPI Number | 1487157830
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Entity Type | Organization
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Legal Business Name | LEX RYDE TRANSPORTATION, LLC
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 347 W 79TH ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-4849
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Country | US
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Telephone | 318-670-3685
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Fax |
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Provider Business Mailing Address
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Address Line | 347 W 79TH ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-4849
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Country | US
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Telephone | 318-670-3685
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SHERILLE RAINEY
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Credential |
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Telephone | 318-670-3685
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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 | LA
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