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General NPI Number Information
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NPI Number | 1639548712
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Entity Type | Organization
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Legal Business Name | SOUTHERN CARE TRANSPORTATION
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 30126 MARCUS RD
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City | BOGALUSA
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State | LA
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Zip | 70463-0776
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Country | US
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Telephone | 950-590-2449
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Fax | 985-886-5544
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Provider Business Mailing Address
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Address Line | PO BOX 776
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City | SUN
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State | LA
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Zip | 70463-0776
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Country | US
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Telephone | 950-590-2449
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Fax | 985-886-5544
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Authorized Official
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Title or Position | PRESIDENT-CEO
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Name | DONALD AMEL BUTLER
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Credential | LBSW/ BBA
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Telephone | 985-590-2449
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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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