Provider Demographics
NPI:1275004780
Name:HERE AND THERE NON EMERGENCY TRANSPORTATION
Entity Type:Organization
Organization Name:HERE AND THERE NON EMERGENCY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHITRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-297-6488
Mailing Address - Street 1:3537 DENNY AVE # 347
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5416
Mailing Address - Country:US
Mailing Address - Phone:228-297-6488
Mailing Address - Fax:228-200-5667
Practice Address - Street 1:3713 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:MOSS POINT
Practice Address - State:MS
Practice Address - Zip Code:39563-6029
Practice Address - Country:US
Practice Address - Phone:228-297-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS100-338-3928Medicaid