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General NPI Number Information
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NPI Number | 1790299345
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Entity Type | Organization
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Legal Business Name | K RENEE NON EMERGENCY MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 11/18/2017
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Last Update Date | 11/18/2017
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Provider Practice Location Address
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Address Line | 426 N MAGNOLIA ST
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City | GRAMERCY
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State | LA
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Zip | 70052
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Country | US
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Telephone | 504-559-6192
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 463
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City | LUTCHER
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State | LA
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Zip | 70071-0463
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Country | US
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Telephone | 504-559-6192
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | KAREN RENEE WALLACE
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Credential |
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Telephone | 504-559-6192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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