Provider Demographics
NPI:1609335561
Name:LEAD MEDICAL TRANSIT LLC
Entity Type:Organization
Organization Name:LEAD MEDICAL TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-366-8499
Mailing Address - Street 1:11832 NEWCASTLE AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8987
Mailing Address - Country:US
Mailing Address - Phone:225-366-8499
Mailing Address - Fax:
Practice Address - Street 1:11832 NEWCASTLE AVE STE 18
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8987
Practice Address - Country:US
Practice Address - Phone:225-366-8499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)