Provider Demographics
NPI:1851910830
Name:STEPPING OUT TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:STEPPING OUT TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-458-3147
Mailing Address - Street 1:420 KINNEY ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-4819
Mailing Address - Country:US
Mailing Address - Phone:662-458-3147
Mailing Address - Fax:
Practice Address - Street 1:523 BRENTWOOD AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-6910
Practice Address - Country:US
Practice Address - Phone:662-458-3147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)