Provider Demographics
NPI:1063917797
Name:CAPITAL CITY TRANSPORTATION LLC.
Entity type:Organization
Organization Name:CAPITAL CITY TRANSPORTATION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHALATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-221-7176
Mailing Address - Street 1:3217 TORONTO DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70819-1848
Mailing Address - Country:US
Mailing Address - Phone:225-221-7176
Mailing Address - Fax:
Practice Address - Street 1:1755 N 16TH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-3510
Practice Address - Country:US
Practice Address - Phone:225-221-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008047566343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)