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NPI 1629957048

OrganizationActive

Madison Grace Transport LLC

NPI 1629957048 · Private Vehicle · Vicksburg, MS

Provider details

NPI number: 1629957048
Entity type: Organization
Primary specialty: Private VehicleTransportation Services
Authorized official: Lawrence Sullivan, Owner

Practice location

126 Le Fleurs Dr

Vicksburg, MS 39180-8850

Phone: (801) 618-0175

More MS providers

Mailing address

126 Le Fleurs Dr

Vicksburg, MS 39180-8850

Registry dates

Enumerated: 2025-08-29
Last updated: 2025-08-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Madison Grace Transport LLC — NPI 1629957048, Vicksburg, MS | NPI Central