Provider Demographics
NPI:1033644752
Name:FONTENO SERVICES LLC
Entity Type:Organization
Organization Name:FONTENO SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:CORNELL
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:504-428-4345
Mailing Address - Street 1:3017 HUNTSVILLE ST
Mailing Address - Street 2:ST
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-4332
Mailing Address - Country:US
Mailing Address - Phone:504-428-4345
Mailing Address - Fax:
Practice Address - Street 1:3017 HUNTSVILLE
Practice Address - Street 2:ST
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:UM
Practice Address - Phone:504-428-4345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008819444343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)