Provider Demographics
NPI:1699328625
Name:RELIABLE TRANSPORTATION LLC
Entity type:Organization
Organization Name:RELIABLE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISPATCHER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BREON
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-620-2594
Mailing Address - Street 1:118 DELPHINE ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3661
Mailing Address - Country:US
Mailing Address - Phone:225-620-2594
Mailing Address - Fax:
Practice Address - Street 1:118 DELPHINE ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3661
Practice Address - Country:US
Practice Address - Phone:225-620-2594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)