Provider Demographics
NPI:1457857377
Name:1029 TRANSPORTATION
Entity Type:Organization
Organization Name:1029 TRANSPORTATION
Other - Org Name:1029 TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEBBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-603-6763
Mailing Address - Street 1:116 N HENNESSEY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-4626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 PERDIDO ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2125
Practice Address - Country:US
Practice Address - Phone:504-603-6763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA00000000OtherNONE