Provider Demographics
NPI:1053924886
Name:B1 NURSING TRANSPORT
Entity type:Organization
Organization Name:B1 NURSING TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAKEBA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-572-7207
Mailing Address - Street 1:208 BOXWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-8006
Mailing Address - Country:US
Mailing Address - Phone:601-307-0857
Mailing Address - Fax:
Practice Address - Street 1:232 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-5134
Practice Address - Country:US
Practice Address - Phone:769-572-7207
Practice Address - Fax:601-510-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS801849213OtherDRIVERS LICENSE