Provider Demographics
NPI:1053957431
Name:ENCORE TRANSPORTATION LLC
Entity type:Organization
Organization Name:ENCORE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-413-8057
Mailing Address - Street 1:12454 WINDERMERE OAKS CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0910
Mailing Address - Country:US
Mailing Address - Phone:225-413-8057
Mailing Address - Fax:225-924-8085
Practice Address - Street 1:12454 WINDERMERE OAKS CT
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-0910
Practice Address - Country:US
Practice Address - Phone:225-413-8057
Practice Address - Fax:225-924-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Single Specialty