Provider Demographics
NPI:1881323467
Name:NICHELLES MEDICAL TRANSIT LLC
Entity type:Organization
Organization Name:NICHELLES MEDICAL TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARLESHIA
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-228-8795
Mailing Address - Street 1:2110 GENERAL ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6854
Mailing Address - Country:US
Mailing Address - Phone:225-228-8795
Mailing Address - Fax:
Practice Address - Street 1:2110 GENERAL ADAMS AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6854
Practice Address - Country:US
Practice Address - Phone:225-228-8795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)