Organization
EMPIRE MEDICAL TRANSPORTATION, LLC
Active
Organization
EMPIRE MEDICAL TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AERIAL RENEE CASTILLO (MANAGER)
(337) 433-5985
Entity
Organization
Contact information
Practice address
1320 BRIDLE WOOD, LAKE CHARLES, LA 70615-5357
(337) 433-5985
(337) 205-2715
Mailing address
PO BOX 16227, LAKE CHARLES, LA 70616-6227
(337) 433-5985
(337) 205-2715
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2387413
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2387413
MOLINA MEDICAID PROVIDER NUMBER
LA
Enumeration date
09/04/2015
Last updated
09/04/2015
Update your record
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