Provider Demographics
NPI:1083235477
Name:FAMILYPASSANGERTRANSPORTS
Entity Type:Organization
Organization Name:FAMILYPASSANGERTRANSPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:504-388-1005
Mailing Address - Street 1:210 E WINTERGREEN RD APT 8208
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2442
Mailing Address - Country:US
Mailing Address - Phone:504-388-1005
Mailing Address - Fax:
Practice Address - Street 1:210 E WINTERGREEN RD APT 8208
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2442
Practice Address - Country:US
Practice Address - Phone:504-388-1005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)