MEDICARE: TIFFINI R BROWN

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	:	1902551864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFINI R BROWN

Provider Business Mailing Address
First Line	:	718 GILLEAS RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38109-3153
Country	:	US
Telephone Number	:	706-761-4323
Fax Number	:

Provider Business Practice Location Address
First Line	:	718 GILLEAS RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38109-3153
Country	:	US
Telephone Number	:	706-761-4323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2022
Last Update Date	:	02/18/2022

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Directions to “ TIFFINI R BROWN ” Practice Location

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