Provider Demographics
NPI:1649446212
Name:CHEYENNE'S TOTAL CARE/TRANSPORATION
Entity type:Organization
Organization Name:CHEYENNE'S TOTAL CARE/TRANSPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MRS. PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-369-0430
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:PRARIE
Mailing Address - State:MS
Mailing Address - Zip Code:39756
Mailing Address - Country:US
Mailing Address - Phone:662-369-0430
Mailing Address - Fax:662-369-0439
Practice Address - Street 1:122 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730
Practice Address - Country:US
Practice Address - Phone:662-369-0430
Practice Address - Fax:662-369-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3780343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)