Provider Demographics
NPI:1467229781
Name:CUS MEDICAL TRANSPORTATION SOLE MBR
Entity Type:Organization
Organization Name:CUS MEDICAL TRANSPORTATION SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEBEDICTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-478-0030
Mailing Address - Street 1:122 E S JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-4154
Mailing Address - Country:US
Mailing Address - Phone:504-478-0030
Mailing Address - Fax:
Practice Address - Street 1:122 E S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-4154
Practice Address - Country:US
Practice Address - Phone:504-478-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle