=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962970855
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBINSONS UNLIMITED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2018
-----------------------------------------------------
Last Update Date | 11/08/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34005 OSPREY DR
-----------------------------------------------------
City | DENHAM SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70706-8646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-439-4255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34005 OSPREY DR
-----------------------------------------------------
City | DENHAM SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70706-8646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-439-4255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | CARLNELL LOUIS ROBINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 225-439-4255
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347C00000X
-----------------------------------------------------
Taxonomy Name | Private Vehicle
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------