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General NPI Number Information
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NPI Number | 1710464722
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Entity Type | Organization
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Legal Business Name | JIFFY CAB, LLC.
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 10 ASHTON RD
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City | BOYCE
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State | LA
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Zip | 71409-9846
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Country | US
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Telephone | 318-729-8294
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Fax |
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Provider Business Mailing Address
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Address Line | 4045 HEYMAN LN APT 118
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2805
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Country | US
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Telephone | 318-729-8294
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID WAYNE SMITH
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Credential |
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Telephone | 318-729-8294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 006360537
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License Number State | LA
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Taxonomy #2
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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 |
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