Provider Demographics
NPI:1154877033
Name:ASSISTANT TRANSPORTATION
Entity type:Organization
Organization Name:ASSISTANT TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-751-6375
Mailing Address - Street 1:1206 GRETCHEN LN
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-5113
Mailing Address - Country:US
Mailing Address - Phone:318-751-6375
Mailing Address - Fax:318-606-3004
Practice Address - Street 1:1206 GRETCHEN LN
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-5113
Practice Address - Country:US
Practice Address - Phone:318-751-6375
Practice Address - Fax:318-606-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010761955343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)