MEDICARE: D&D ENTERPRISE LLC

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)	112004594	TN

General Provider Information

NPI Number	:	1962748483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&D ENTERPRISE LLC

Provider Business Mailing Address
First Line	:	8831 GRAND SLAM DR
Second Line	:	203
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2588
Country	:	US
Telephone Number	:	901-500-5008
Fax Number	:

Provider Business Practice Location Address
First Line	:	8831 GRAND SLAM DR
Second Line	:	203
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2588
Country	:	US
Telephone Number	:	901-500-5008
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DASSE ROMAIN YOBO
Credential	:
Telephone Number	:	901-500-5008

Provider Enumeration Date	:	01/02/2013
Last Update Date	:	01/10/2013

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Directions to “D&D ENTERPRISE LLC ” Practice Location

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