Provider Demographics
NPI:1467160374
Name:SPAIN TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:SPAIN TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-733-6695
Mailing Address - Street 1:4510 SUGAR HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:ADDIS
Mailing Address - State:LA
Mailing Address - Zip Code:70710-2203
Mailing Address - Country:US
Mailing Address - Phone:225-960-1348
Mailing Address - Fax:
Practice Address - Street 1:4510 SUGAR HOLLOW LN
Practice Address - Street 2:
Practice Address - City:ADDIS
Practice Address - State:LA
Practice Address - Zip Code:70710-2203
Practice Address - Country:US
Practice Address - Phone:225-960-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)