Provider Demographics
NPI:1891394979
Name:M.D.O. TRANSPORTATION LLC
Entity Type:Organization
Organization Name:M.D.O. TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEMETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-516-9285
Mailing Address - Street 1:621 ELMWOOD PARK BLVD # F2134
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-3300
Mailing Address - Country:US
Mailing Address - Phone:504-516-9285
Mailing Address - Fax:
Practice Address - Street 1:621 ELMWOOD PARK BLVD # F2134
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-3300
Practice Address - Country:US
Practice Address - Phone:504-516-9285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)