Provider Demographics
NPI:1154197549
Name:PINEY WOODS FIRST CLASS TRANSPORTATION LLC
Entity type:Organization
Organization Name:PINEY WOODS FIRST CLASS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-564-6310
Mailing Address - Street 1:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:HODGE
Mailing Address - State:LA
Mailing Address - Zip Code:71247-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 VAN BUREN DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2221
Practice Address - Country:US
Practice Address - Phone:318-564-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle