Provider Demographics
NPI:1154427235
Name:LEBONHEUR PATIENT TRANSPORTATION
Entity type:Organization
Organization Name:LEBONHEUR PATIENT TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRILE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-572-5921
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-0379
Mailing Address - Country:US
Mailing Address - Phone:901-572-5921
Mailing Address - Fax:
Practice Address - Street 1:50 N DUNLAP ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2800
Practice Address - Country:US
Practice Address - Phone:901-572-5921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000100323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4126201OtherBC/BS TENNESSEE