MEDICARE: J-3 DISPATCHERS 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1487476537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J-3 DISPATCHERS LLC

Provider Business Mailing Address
First Line	:	6014 LANIER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-2312
Country	:	US
Telephone Number	:	225-362-7736
Fax Number	:

Provider Business Practice Location Address
First Line	:	6014 LANIER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-2312
Country	:	US
Telephone Number	:	225-362-7736
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. DEROSSIC LEE ALLEN JR.
Credential	:
Telephone Number	:	225-362-7736

Provider Enumeration Date	:	10/29/2024
Last Update Date	:	10/29/2024

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