Provider Demographics
NPI:1164819942
Name:LARDSE
Entity Type:Organization
Organization Name:LARDSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-701-0133
Mailing Address - Street 1:2401 ELM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068
Mailing Address - Country:US
Mailing Address - Phone:214-701-0133
Mailing Address - Fax:
Practice Address - Street 1:2401 ELM VALLEY DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068
Practice Address - Country:US
Practice Address - Phone:214-701-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)