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General NPI Number Information
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NPI Number | 1710845953
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Entity Type | Organization
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Legal Business Name | GRACELINE TRANSPORT LLC
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 4148 PINES RD
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City | SHREVEPORT
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State | LA
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Zip | 71119-7311
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Country | US
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Telephone | 318-716-0958
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Fax |
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Provider Business Mailing Address
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Address Line | 4148 PINES RD
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City | SHREVEPORT
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State | LA
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Zip | 71119-7311
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Country | US
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Telephone | 318-716-0958
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VENCENTRIA SANDERS
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Credential |
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Telephone | 318-205-4710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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