MEDICARE: DUKE-DUCHESSTRANSPORTATION

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1548413651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUKE-DUCHESSTRANSPORTATION

Provider Business Mailing Address
First Line	:	3915 PATTE ANN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116
Country	:	UM
Telephone Number	:	901-345-8537
Fax Number	:	901-327-0907

Provider Business Practice Location Address
First Line	:	3915 PATTE ANN DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116-5623
Country	:	US
Telephone Number	:	901-345-8537
Fax Number	:	901-327-0907

Authorized Official
Title or Position	:	OWNER
Name	:	SUSIE L HARRIS
Credential	:
Telephone Number	:	901-345-8537

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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