Provider Demographics
NPI:1275240459
Name:GREENLIGHT MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GREENLIGHT MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JHADE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-229-5906
Mailing Address - Street 1:6227 CRESTWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70812-1531
Mailing Address - Country:US
Mailing Address - Phone:225-229-5906
Mailing Address - Fax:
Practice Address - Street 1:6227 CRESTWAY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-1531
Practice Address - Country:US
Practice Address - Phone:225-229-5906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)