Provider Demographics
NPI:1639925761
Name:J3 RELIABLE TRANSPORT LLC
Entity type:Organization
Organization Name:J3 RELIABLE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONALDLYN
Authorized Official - Middle Name:JEANEICE
Authorized Official - Last Name:SHOULDERS-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-617-5653
Mailing Address - Street 1:20136 HWY 18
Mailing Address - Street 2:
Mailing Address - City:HERMANVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39086
Mailing Address - Country:US
Mailing Address - Phone:601-617-5653
Mailing Address - Fax:
Practice Address - Street 1:20136 HWY 18
Practice Address - Street 2:
Practice Address - City:HERMANVILLE
Practice Address - State:MS
Practice Address - Zip Code:39086
Practice Address - Country:US
Practice Address - Phone:601-617-5653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)