Provider Demographics
NPI:1669181863
Name:5IVE JS
Entity type:Organization
Organization Name:5IVE JS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-716-1906
Mailing Address - Street 1:59775 AVERY JAMES DR
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-5274
Mailing Address - Country:US
Mailing Address - Phone:225-716-1906
Mailing Address - Fax:225-647-8705
Practice Address - Street 1:59775 AVERY JAMES DR
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-5274
Practice Address - Country:US
Practice Address - Phone:225-716-1906
Practice Address - Fax:225-647-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)