Provider Demographics
NPI:1861269730
Name:STEPPED OUT ON FAITH TRANSPORTATION (SOOF)
Entity type:Organization
Organization Name:STEPPED OUT ON FAITH TRANSPORTATION (SOOF)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MYISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-230-6948
Mailing Address - Street 1:940 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2812
Mailing Address - Country:US
Mailing Address - Phone:318-230-6948
Mailing Address - Fax:
Practice Address - Street 1:940 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2812
Practice Address - Country:US
Practice Address - Phone:318-230-6948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)