Provider Demographics
NPI:1609435064
Name:J AND L A1 TRANSPORTATION
Entity type:Organization
Organization Name:J AND L A1 TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FO5RD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-926-0640
Mailing Address - Street 1:3255 LOTTA RD
Mailing Address - Street 2:
Mailing Address - City:KARNACK
Mailing Address - State:TX
Mailing Address - Zip Code:75661-2159
Mailing Address - Country:US
Mailing Address - Phone:903-926-0640
Mailing Address - Fax:
Practice Address - Street 1:3921 EILEEN LN
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-1921
Practice Address - Country:US
Practice Address - Phone:903-926-0640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)