Provider Demographics
NPI:1881412385
Name:ACTIVE TRANSPORTATION, LLC
Entity type:Organization
Organization Name:ACTIVE TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-454-4333
Mailing Address - Street 1:6803 BAYOU SARA WAY
Mailing Address - Street 2:
Mailing Address - City:ST. FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775-6684
Mailing Address - Country:US
Mailing Address - Phone:225-454-4333
Mailing Address - Fax:
Practice Address - Street 1:6803 BAYOU SARA WAY
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-6684
Practice Address - Country:US
Practice Address - Phone:225-603-1408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)