Provider Demographics
NPI:1093167512
Name:P&M MEDICAL TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:P&M MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-534-0955
Mailing Address - Street 1:401 AUDUBON BLVD STE 206C
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2676
Mailing Address - Country:US
Mailing Address - Phone:337-534-0955
Mailing Address - Fax:337-593-0098
Practice Address - Street 1:401 AUDUBON BLVD STE 206C
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2676
Practice Address - Country:US
Practice Address - Phone:337-534-0955
Practice Address - Fax:337-593-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)