Provider Demographics
NPI:1861860371
Name:ROSE'S TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:ROSE'S TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:ETTA
Authorized Official - Last Name:HITCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-719-3171
Mailing Address - Street 1:170 PEARL AND MARTHA RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:LA
Mailing Address - Zip Code:70441-3664
Mailing Address - Country:US
Mailing Address - Phone:225-719-3171
Mailing Address - Fax:225-222-3148
Practice Address - Street 1:170 PEARL AND MARTHA RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:LA
Practice Address - Zip Code:70441-3664
Practice Address - Country:US
Practice Address - Phone:225-719-3171
Practice Address - Fax:225-222-3148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2359461343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2359461Medicaid