Organization
LOUISIANA MEDIC TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAISTA WAQAR SIDDIQUI (MEMBER/OWNER)
(318) 820-0094
Entity
Organization
Contact information
Practice address
223 LAKE VILLAGE DR, WEST MONROE, LA 71291-9035
(318) 820-0094
Mailing address
223 LAKE VILLAGE DR, WEST MONROE, LA 71291-9035
(318) 820-0094
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
17496 PT
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
A826612
LA
343900000X
Non-emergency Medical Transport (VAN)
A826613
LA
Other
Enumeration date
10/25/2016
Last updated
01/25/2017
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