Stefan Stewart

Individual provider Active NPI Driver · Bastrop, LA

NPI 1962069641 · NPPES record last updated May 28, 2019

Key facts

NPI
1962069641
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
007854006 (LA)
Practice address
510 Gunby Ave
Bastrop, LA 71220-4408
Phone
(318) 376-7581
Fax
(318) 974-3312
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
007854006LAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
C&S Transportation Service LLC Current
since Jul 28, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 007854006 LA Yes

Addresses

Primary practice location

510 Gunby Ave
Bastrop, LA 71220-4408

Mailing address

510 Gunby Ave
Bastrop, LA 71220-4408
Phone (318) 376-7581

Other providers in Bastrop, LA

All providers in Bastrop, LA · Driver in Louisiana

Sources for this page

Verify at the official NPI Registry.