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NPI 1720630841

NPI 1720630841 : LETS RIDE TRANSPORT LLC : BOUTTE, LA

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General NPI Number Information
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    NPI Number           |    1720630841
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    Entity Type          |    Organization 
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    Legal Business Name  |    LETS RIDE TRANSPORT LLC 
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Dates
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    Enumeration Date     |    07/09/2019
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    Last Update Date     |    07/09/2019
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Provider Practice Location Address
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    Address Line         |    378 SOUTH KINLER ST 
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    City                 |    BOUTTE
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    State                |    LA
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    Zip                  |    70039
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    Country              |    US
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    Telephone            |    504-957-4592
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1136 
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    City                 |    LULING
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    State                |    LA
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    Zip                  |    70070-1136
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     TIFFANY  DEE 
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    Credential           |    
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    Telephone            |    504-957-4592
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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 |    
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