Provider Demographics
NPI:1033741350
Name:SUTHERN MAGNOLIAN NEMT LLC
Entity Type:Organization
Organization Name:SUTHERN MAGNOLIAN NEMT LLC
Other - Org Name:SUTHERN MAGNOLIAN NEMT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DELONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-535-1727
Mailing Address - Street 1:650 POYDRAS ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-6116
Mailing Address - Country:US
Mailing Address - Phone:504-526-4722
Mailing Address - Fax:
Practice Address - Street 1:650 POYDRAS ST STE 1400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-6116
Practice Address - Country:US
Practice Address - Phone:504-526-4722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered Meals