Provider Demographics
NPI:1043975097
Name:ESSENTIA TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ESSENTIA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUAI
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-349-2809
Mailing Address - Street 1:12 GOLF CLUB DR
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-8609
Mailing Address - Country:US
Mailing Address - Phone:318-349-2808
Mailing Address - Fax:
Practice Address - Street 1:12 GOLF CLUB DR
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-8609
Practice Address - Country:US
Practice Address - Phone:318-349-2808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle