MEDICARE: S&C SIERRA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	156027048	OTHER		SELF

General Provider Information

NPI Number	:	1063920205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S&C SIERRA LLC

Provider Business Mailing Address
First Line	:	9800 AIRLINE HWY STE 121
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-8000
Country	:	US
Telephone Number	:	551-655-3285
Fax Number	:

Provider Business Practice Location Address
First Line	:	12773 BROGDON LN STE 300
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4860
Country	:	US
Telephone Number	:	225-248-6546
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEJANDRO M SIERRA
Credential	:
Telephone Number	:	551-655-3285

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	11/06/2020

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Directions to “S&C SIERRA LLC ” Practice Location

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