Provider Demographics
NPI:1699519058
Name:BLACKBYRD THE CARRIER COMPANY
Entity type:Organization
Organization Name:BLACKBYRD THE CARRIER COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHARD GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-324-1105
Mailing Address - Street 1:440 LOUISIANA ST STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-1062
Mailing Address - Country:US
Mailing Address - Phone:833-324-1105
Mailing Address - Fax:
Practice Address - Street 1:440 LOUISIANA ST STE 900
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-1062
Practice Address - Country:US
Practice Address - Phone:833-324-1105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)