Provider Demographics
NPI:1235840141
Name:PORTER TRANSPORTATION LLC
Entity Type:Organization
Organization Name:PORTER TRANSPORTATION LLC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHEADRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:409-383-8350
Mailing Address - Street 1:3004 OAK CREST ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-2065
Mailing Address - Country:US
Mailing Address - Phone:409-338-2760
Mailing Address - Fax:
Practice Address - Street 1:3004 OAK CREST ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-2065
Practice Address - Country:US
Practice Address - Phone:409-338-2760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1790452746OtherNATIONAL PROVIDER NUMBER-INDIVIDUAL