Provider Demographics
NPI:1326756560
Name:PIC ME UP MEDICAL TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:PIC ME UP MEDICAL TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-419-8326
Mailing Address - Street 1:1216 OKLAHOMA ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-3624
Mailing Address - Country:US
Mailing Address - Phone:337-419-8326
Mailing Address - Fax:
Practice Address - Street 1:1216 OKLAHOMA ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-3624
Practice Address - Country:US
Practice Address - Phone:337-419-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)