| NPI | 1710780648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE C LUCKETT Manager 601-260-8526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-06-08 |