Provider Demographics
NPI:1912710823
Name:EXCLUSIVE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:EXCLUSIVE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HUMAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-680-6792
Mailing Address - Street 1:314 FRENCHMANS PLACE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-7120
Mailing Address - Country:US
Mailing Address - Phone:318-680-6792
Mailing Address - Fax:
Practice Address - Street 1:1205 N 18TH ST STE 21
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5461
Practice Address - Country:US
Practice Address - Phone:318-680-6792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)