Provider Demographics
NPI:1548767965
Name:J&D TRANSIT REGISTERED LLC OF MS
Entity Type:Organization
Organization Name:J&D TRANSIT REGISTERED LLC OF MS
Other - Org Name:J&D TRANSIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-684-8800
Mailing Address - Street 1:1240 SPRINGRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-6528
Mailing Address - Country:US
Mailing Address - Phone:601-684-8800
Mailing Address - Fax:
Practice Address - Street 1:1240 SPRINGRIDGE RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-6528
Practice Address - Country:US
Practice Address - Phone:601-684-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1174934590Medicaid