Organization
MELANCON'S RIDE THERAPY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEITRAS K MELANCON SR. (OWNER)
(504) 818-6015
Entity
Organization
Contact information
Practice address
4219 S BROAD ST, NEW ORLEANS, LA 70125-3659
(504) 818-6015
(504) 309-1930
Mailing address
4219 S BROAD ST, NEW ORLEANS, LA 70125-3659
(504) 818-6015
(504) 309-1930
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
6004233
LA
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6004233
TRANSPOTATION
LA
Enumeration date
09/19/2017
Last updated
05/22/2025
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