MEDICARE: TM TRANSPORTATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1407492390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TM TRANSPORTATION INC

Provider Business Mailing Address
First Line	:	4202 WALLINGFORD LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-2720
Country	:	US
Telephone Number	:	502-345-7452
Fax Number	:

Provider Business Practice Location Address
First Line	:	4202 WALLINGFORD LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-2720
Country	:	US
Telephone Number	:	502-345-7452
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MOHAMEDOU TEYIB
Credential	:
Telephone Number	:	502-345-7452

Provider Enumeration Date	:	11/26/2019
Last Update Date	:	11/26/2019

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Directions to “TM TRANSPORTATION INC ” Practice Location

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