# MEDI TRANS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689881575
- **Authorized official:** PAUL A. BROUSSARD (CEO)
- **Authorized official phone:** (337) 534-4484

## Contact information

- **Practice address:** 102 ASMA BLVD STE 200, LAFAYETTE, LA 70508-3843
- **Practice address phone:** (337) 366-6618
- **Practice address fax:** (337) 534-4485
- **Mailing address:** 102 ASMA BLVD STE 200, LAFAYETTE, LA 70508-3843
- **Mailing address phone:** (337) 366-6618
- **Mailing address fax:** (337) 534-4485

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347E00000X | Transportation Broker | — | NULL | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 01/23/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1011053 | — | LA |