Provider Demographics
NPI:1558027797
Name:ABBEY ONE TRANSPORTERS LLC
Entity Type:Organization
Organization Name:ABBEY ONE TRANSPORTERS LLC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:K
Authorized Official - Last Name:ABBEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:901-299-2784
Mailing Address - Street 1:704 SAINT REGIS
Mailing Address - Street 2:
Mailing Address - City:WEST HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72390-2036
Mailing Address - Country:US
Mailing Address - Phone:901-299-2784
Mailing Address - Fax:
Practice Address - Street 1:704 SAINT REGIS
Practice Address - Street 2:
Practice Address - City:WEST HELENA
Practice Address - State:AR
Practice Address - Zip Code:72390-2036
Practice Address - Country:US
Practice Address - Phone:901-299-2784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1669015863Medicaid