Provider Demographics
NPI:1891304507
Name:SUNSHINE TRANSPORTATION OF SHREVEPORT LLC
Entity Type:Organization
Organization Name:SUNSHINE TRANSPORTATION OF SHREVEPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-489-5720
Mailing Address - Street 1:5202 ELLISON ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-7336
Mailing Address - Country:US
Mailing Address - Phone:318-489-5720
Mailing Address - Fax:
Practice Address - Street 1:5202 ELLISON ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-7336
Practice Address - Country:US
Practice Address - Phone:318-489-5720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)