Organization
MEDI TRANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL A. BROUSSARD (CEO)
(337) 534-4484
Entity
Organization
Contact information
Practice address
102 ASMA BLVD STE 200, LAFAYETTE, LA 70508-3843
(337) 366-6618
(337) 534-4485
Mailing address
102 ASMA BLVD STE 200, LAFAYETTE, LA 70508-3843
(337) 366-6618
(337) 534-4485
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011053
—
LA
Enumeration date
05/17/2007
Last updated
01/23/2023
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