MEDICARE: GRACELINE TRANSPORT 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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1710845953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACELINE TRANSPORT LLC

Provider Business Mailing Address
First Line	:	4148 PINES RD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71119-7311
Country	:	US
Telephone Number	:	318-716-0958
Fax Number	:

Provider Business Practice Location Address
First Line	:	4148 PINES RD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71119-7311
Country	:	US
Telephone Number	:	318-716-0958
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VENCENTRIA SANDERS
Credential	:
Telephone Number	:	318-205-4710

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

Similar Medicare Providers

1568173599 — LATOYA LATRICE THOMAS
Practice Location Address:

4132 PINES RD
SHREVEPORT, LA
71119-7311

Practice Phone: 318-655-4950
Practice Fax:

1750373338 — DAVID N ADAMS MD
Practice Location Address:

5709 SHORELINE DR
SHREVEPORT, LA
71119-3911

Practice Phone: 318-334-0768
Practice Fax:

1750348462 — DEPARTMENT OF HEALTH AND HOSPITALS
Practice Location Address:

6240 GREENWOOD RD
SHREVEPORT, LA
71119-8413

Practice Phone: 318-632-2010
Practice Fax: 318-632-2055

1386601425 — DEPARTMENT OF HEALTH AND HOSPITALS
Practice Location Address:

6240 GREENWOOD RD
SHREVEPORT, LA
71119-8413

Practice Phone: 318-632-2010
Practice Fax: 318-632-2055

1689600025 — GREGORY R PALLAY LPC , LMFT
Practice Location Address:

6240 GREENWOOD RD
SHREVEPORT, LA
71119-8413

Practice Phone: 318-632-2010
Practice Fax: 318-632-2055

1407883879 — MYRA CARTER LAC
Practice Location Address:

6240 GREENWOOD RD
SHREVEPORT, LA
71119-8413

Practice Phone: 318-632-2010
Practice Fax: 318-632-2055

Directions to “GRACELINE TRANSPORT LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.