Organization
B1 NURSING TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAKEBA C WHITE (CEO)
(769) 572-7207
Entity
Organization
Contact information
Practice address
232 SAINT PAUL ST, PEARL, MS 39208-5134
(769) 572-7207
(601) 510-4844
Mailing address
208 BOXWOOD CIR, BRANDON, MS 39047-8006
(601) 307-0857
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801849213
DRIVERS LICENSE
MS
Enumeration date
08/31/2020
Last updated
08/31/2020
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