Provider Demographics
NPI:1376387621
Name:LAVELL'S MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:LAVELL'S MEDICAL TRANSPORTATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARRINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-235-9697
Mailing Address - Street 1:3200 EARLE DR
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-4038
Mailing Address - Country:US
Mailing Address - Phone:318-235-9697
Mailing Address - Fax:
Practice Address - Street 1:3200 EARLE DR
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-4038
Practice Address - Country:US
Practice Address - Phone:318-235-9697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)