Provider Demographics
NPI:1497486641
Name:NOAH'S ARK TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:NOAH'S ARK TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRONDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:TISDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-506-0630
Mailing Address - Street 1:630 W PRIEN LAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-0700
Mailing Address - Country:US
Mailing Address - Phone:281-506-0630
Mailing Address - Fax:800-391-2426
Practice Address - Street 1:630 W PRIEN LAKE RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-0700
Practice Address - Country:US
Practice Address - Phone:281-506-0630
Practice Address - Fax:800-391-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)