Provider Demographics
NPI:1811334428
Name:IMPRESSIVE TRANSPORTATION LLC
Entity type:Organization
Organization Name:IMPRESSIVE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:NICHOLLE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-298-2878
Mailing Address - Street 1:1814 CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2712
Mailing Address - Country:US
Mailing Address - Phone:504-298-2878
Mailing Address - Fax:
Practice Address - Street 1:1814 CEDARWOOD AVE
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-2712
Practice Address - Country:US
Practice Address - Phone:504-298-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10376891#YYN83343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)