MEDICARE: CLARA'S TRANSPORTATION SERVICE 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)

General Provider Information

NPI Number	:	1891407128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARA'S TRANSPORTATION SERVICE LLC

Provider Business Mailing Address
First Line	:	2252 SHADY OAKS DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2278
Country	:	US
Telephone Number	:	225-200-0749
Fax Number	:

Provider Business Practice Location Address
First Line	:	2252 SHADY OAKS DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-2278
Country	:	US
Telephone Number	:	225-200-0749
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	NEDRA HILL
Credential	:
Telephone Number	:	225-200-0749

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	12/19/2022

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