=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780238998
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZEBRA TRANSPORTATION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2019
-----------------------------------------------------
Last Update Date | 07/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 342 COLD WATER BND
-----------------------------------------------------
City | HOLLY SPRINGS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38635-8728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-851-2056
-----------------------------------------------------
Fax | 662-851-2060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 342 COLD WATER BND
-----------------------------------------------------
City | HOLLY SPRINGS
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38635-8728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-851-2056
-----------------------------------------------------
Fax | 662-851-2060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MRS. SHAREEKA MANNEH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-851-2056
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------