Provider Demographics
NPI:1922749316
Name:GREENWOOD TRANS AND SUPPORT LLC
Entity Type:Organization
Organization Name:GREENWOOD TRANS AND SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-261-3503
Mailing Address - Street 1:528 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-8100
Mailing Address - Country:US
Mailing Address - Phone:504-344-4854
Mailing Address - Fax:
Practice Address - Street 1:1919 VETERANS MEMORIAL BLVD SUITE 305
Practice Address - Street 2:SUITE 302
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-7006
Practice Address - Country:US
Practice Address - Phone:504-344-4854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1871055053Medicaid