Provider Demographics
NPI:1578960746
Name:JOEDREAD ENTERPRISES, LLC
Entity Type:Organization
Organization Name:JOEDREAD ENTERPRISES, LLC
Other - Org Name:JOEDREAD ENTERPRISES, LLC TRANSPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:HAULSEY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:504-715-7049
Mailing Address - Street 1:PO BOX 8966
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71148-8966
Mailing Address - Country:US
Mailing Address - Phone:318-602-0963
Mailing Address - Fax:
Practice Address - Street 1:2054 HOLLY OAK DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-4713
Practice Address - Country:US
Practice Address - Phone:318-602-0963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X, 347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus