Provider Demographics
NPI:1033677802
Name:SAFE PASSAGE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SAFE PASSAGE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VONDRICK
Authorized Official - Middle Name:JAMAL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-382-2944
Mailing Address - Street 1:16796 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-6406
Mailing Address - Country:US
Mailing Address - Phone:318-382-2944
Mailing Address - Fax:318-382-0176
Practice Address - Street 1:16796 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-6406
Practice Address - Country:US
Practice Address - Phone:318-382-2944
Practice Address - Fax:318-382-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)