Provider Demographics
NPI:1316554991
Name:ZYDECO NON-EMERGENCY MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ZYDECO NON-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HAUGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-791-3332
Mailing Address - Street 1:216 LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3204
Mailing Address - Country:US
Mailing Address - Phone:318-791-3332
Mailing Address - Fax:
Practice Address - Street 1:216 LAUREL CT
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-3204
Practice Address - Country:US
Practice Address - Phone:318-791-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)