Provider Demographics
NPI:1750139283
Name:SMSS PROFESSIONS, LLC
Entity type:Organization
Organization Name:SMSS PROFESSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATISEA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-293-4755
Mailing Address - Street 1:2211 N ROBISON RD UNIT 6989
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-5779
Mailing Address - Country:US
Mailing Address - Phone:903-293-4755
Mailing Address - Fax:
Practice Address - Street 1:2211 N ROBISON RD UNIT 6989
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75505-5779
Practice Address - Country:US
Practice Address - Phone:903-293-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)