Provider Demographics
NPI:1912774852
Name:ASAP MEDIVANS, LLC
Entity type:Organization
Organization Name:ASAP MEDIVANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MMBR
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:985-507-1441
Mailing Address - Street 1:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-0519
Mailing Address - Country:US
Mailing Address - Phone:985-306-5764
Mailing Address - Fax:
Practice Address - Street 1:14065 HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454
Practice Address - Country:US
Practice Address - Phone:985-507-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)