Provider Demographics
NPI:1003352824
Name:SYNERGIST TRANSPORTATION
Entity Type:Organization
Organization Name:SYNERGIST TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-502-2619
Mailing Address - Street 1:PO BOX 66131
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-6131
Mailing Address - Country:US
Mailing Address - Phone:225-502-2619
Mailing Address - Fax:225-421-1830
Practice Address - Street 1:2001 S SHERWOOD FOREST BLVD
Practice Address - Street 2:APT. 413
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8406
Practice Address - Country:US
Practice Address - Phone:225-502-2619
Practice Address - Fax:225-421-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00922410343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)