Provider Demographics
NPI:1376904151
Name:MAMA'S MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:MAMA'S MEDICAL TRANSPORTATION
Other - Org Name:MAMA'STRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-276-4408
Mailing Address - Street 1:2727 NORTH ARDENWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805
Mailing Address - Country:US
Mailing Address - Phone:225-276-4408
Mailing Address - Fax:
Practice Address - Street 1:2727 NORTH ARDENWOOD DR.
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805
Practice Address - Country:US
Practice Address - Phone:225-421-1125
Practice Address - Fax:225-421-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)