Provider Demographics
NPI:1598288862
Name:KAZIST LLC
Entity Type:Organization
Organization Name:KAZIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NYEKAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-481-6652
Mailing Address - Street 1:392 MANSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-7318
Mailing Address - Country:US
Mailing Address - Phone:504-481-6452
Mailing Address - Fax:985-605-7228
Practice Address - Street 1:2138 SELMA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4040
Practice Address - Country:US
Practice Address - Phone:504-481-6652
Practice Address - Fax:985-605-7228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QR1100X, 343900000X, 344600000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No344600000XTransportation ServicesTaxi
No347E00000XTransportation ServicesTransportation Broker