Provider Demographics
NPI:1801671417
Name:LP RELIABLE TRANSPORTATION
Entity type:Organization
Organization Name:LP RELIABLE TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-270-4784
Mailing Address - Street 1:12625 S ALPINE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:ALSIP
Mailing Address - State:IL
Mailing Address - Zip Code:60803-3318
Mailing Address - Country:US
Mailing Address - Phone:708-270-4784
Mailing Address - Fax:
Practice Address - Street 1:12625 S ALPINE DR APT 2
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-3318
Practice Address - Country:US
Practice Address - Phone:708-270-4784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LP RELIABLE TRANSPORTATION COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-30
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)