=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760234504
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REGAL TRANSPORTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2024
-----------------------------------------------------
Last Update Date | 04/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2320 DRUSILLA LN STE A #1059
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-506-8579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3484 CEDARCREST AVE APT 1201
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70816-2092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TSHWANNA LITTLES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 225-506-8825
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------