Provider Demographics
NPI:1639548712
Name:SOUTHERN CARE TRANSPORTATION
Entity Type:Organization
Organization Name:SOUTHERN CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:AMEL
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW/ BBA
Authorized Official - Phone:985-590-2449
Mailing Address - Street 1:PO BOX 776
Mailing Address - Street 2:
Mailing Address - City:SUN
Mailing Address - State:LA
Mailing Address - Zip Code:70463-0776
Mailing Address - Country:US
Mailing Address - Phone:950-590-2449
Mailing Address - Fax:985-886-5544
Practice Address - Street 1:30126 MARCUS RD
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70463-0776
Practice Address - Country:US
Practice Address - Phone:950-590-2449
Practice Address - Fax:985-886-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2191721Medicaid