Provider Demographics
NPI:1609348010
Name:L&R TRANSPORTATION
Entity Type:Organization
Organization Name:L&R TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOUFOUTAHO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIASSOU
Authorized Official - Suffix:
Authorized Official - Credentials:TRANSPORT PROVIDER
Authorized Official - Phone:401-601-5857
Mailing Address - Street 1:59 IONA ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2307
Mailing Address - Country:US
Mailing Address - Phone:401-601-5857
Mailing Address - Fax:
Practice Address - Street 1:59 IONA ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-2307
Practice Address - Country:US
Practice Address - Phone:401-601-5857
Practice Address - Fax:401-270-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-24
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Single Specialty