Organization
ICONIC MEDICAL TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATA WOMACK (OWNER)
(225) 424-3585
Entity
Organization
Contact information
Practice address
4775 LOIS DR, ZACHARY, LA 70791-3917
(225) 424-3585
(225) 570-2929
Mailing address
4775 LOIS DR, ZACHARY, LA 70791-3917
(225) 424-3585
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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