Organization
LYSA TRANSPORTATION SERVICE LLC
Active
Other names
LYSA TRANSPORTATION SERVICE LLC/CED JOHNSON
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIQUZE JOHNSON (OWNER)
(318) 572-2566
Entity
Organization
Contact information
Practice address
3118 WALLACE DR, SHREVEPORT, LA 71119-3306
(318) 572-2566
Mailing address
3118 WALLACE DR, SHREVEPORT, LA 71119-3306
(318) 572-2566
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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