Provider Demographics
NPI:1215650312
Name:FAITH TRANSPORTATION LLC
Entity type:Organization
Organization Name:FAITH TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALENCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-708-9431
Mailing Address - Street 1:2208 MUNSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:MERAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70075-2410
Mailing Address - Country:US
Mailing Address - Phone:504-563-1904
Mailing Address - Fax:
Practice Address - Street 1:2208 MUNSTER BLVD
Practice Address - Street 2:
Practice Address - City:MERAUX
Practice Address - State:LA
Practice Address - Zip Code:70075-2410
Practice Address - Country:US
Practice Address - Phone:504-708-9431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1215650312Medicaid