Provider Demographics
NPI:1780305565
Name:EXODUS MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:EXODUS MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SORITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELZEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-981-4358
Mailing Address - Street 1:47378 ETHAN CT STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-7218
Mailing Address - Country:US
Mailing Address - Phone:985-551-1339
Mailing Address - Fax:985-387-8816
Practice Address - Street 1:47378 ETHAN CT STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-7218
Practice Address - Country:US
Practice Address - Phone:985-981-8810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)