Provider Demographics
NPI:1891285847
Name:CENTRAL LOUISIANA MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:CENTRAL LOUISIANA MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:BELAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-447-4758
Mailing Address - Street 1:2208 BONAVENTURE CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3374
Mailing Address - Country:US
Mailing Address - Phone:318-447-4758
Mailing Address - Fax:318-963-8799
Practice Address - Street 1:2208 BONAVENTURE CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3374
Practice Address - Country:US
Practice Address - Phone:318-447-4758
Practice Address - Fax:318-963-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)