Provider Demographics
NPI:1154817252
Name:MORNING STAR TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:MORNING STAR TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:601-441-2515
Mailing Address - Street 1:1351 GATES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MS
Mailing Address - Zip Code:39429-8948
Mailing Address - Country:US
Mailing Address - Phone:601-441-2515
Mailing Address - Fax:
Practice Address - Street 1:1749 GATES RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-8828
Practice Address - Country:US
Practice Address - Phone:601-441-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)