| NPI | 1750540530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RESHONDA L MCKINNEY-KING Administrator 901-395-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000000971) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: TN T000356) |
| 347C00000X Private Vehicle (Licence: TN T000356) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2012-09-10 |