Provider Demographics
NPI:1821575614
Name:SNJ TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:SNJ TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:GILSON
Authorized Official - Last Name:MINNIEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-207-4948
Mailing Address - Street 1:4 SHANNON FERGUSON CV
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-3102
Mailing Address - Country:US
Mailing Address - Phone:662-207-4948
Mailing Address - Fax:
Practice Address - Street 1:4 SHANNON FERGUSON CV
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-3102
Practice Address - Country:US
Practice Address - Phone:662-207-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)