Provider Demographics
NPI:1740659416
Name:JACY'S NON-EMERGENCY MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:JACY'S NON-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-912-7319
Mailing Address - Street 1:2623 LAW ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-7513
Mailing Address - Country:US
Mailing Address - Phone:504-912-7319
Mailing Address - Fax:504-324-5959
Practice Address - Street 1:2623 LAW ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-7513
Practice Address - Country:US
Practice Address - Phone:504-912-7319
Practice Address - Fax:504-324-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)