Provider Demographics
NPI:1417610312
Name:AFFIANCE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:AFFIANCE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VARHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT
Authorized Official - Phone:225-678-0650
Mailing Address - Street 1:105 VAIL DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-7367
Mailing Address - Country:US
Mailing Address - Phone:504-458-3460
Mailing Address - Fax:318-342-3233
Practice Address - Street 1:105 VAIL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-7367
Practice Address - Country:US
Practice Address - Phone:504-458-3460
Practice Address - Fax:318-342-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)