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General NPI Number Information
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NPI Number | 1871820225
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Entity Type | Organization
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Legal Business Name | QUALITY MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 810 WINNSBORO ROAD 602 GRAYLING LANE
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City | MONROE
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State | LA
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Zip | 71202
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Country | US
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Telephone | 318-267-6265
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Fax |
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Provider Business Mailing Address
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Address Line | 810 WINNSBORO RD 602 GRAYLING LANE
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City | MONROE
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State | LA
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Zip | 71202-3445
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Country | US
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Telephone | 318-267-6265
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MR. LARRY L HARRIS
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Credential |
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Telephone | 31832676265
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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 | 090138
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License Number State | LA
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