Provider Demographics
NPI:1073079000
Name:COMMUNITY MED TRANS LLC
Entity Type:Organization
Organization Name:COMMUNITY MED TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PIKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-802-4727
Mailing Address - Street 1:12765 MIDDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-4834
Mailing Address - Country:US
Mailing Address - Phone:225-802-4727
Mailing Address - Fax:225-778-5777
Practice Address - Street 1:12765 MIDDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-4834
Practice Address - Country:US
Practice Address - Phone:225-802-4727
Practice Address - Fax:225-778-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)