Healthcare Provider Details

I. General information

NPI: 1336879121
Provider Name (Legal Business Name): TNT INDUSTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 07/17/2022
Certification Date: 07/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3246 ERNEST ST
JACKSONVILLE FL
32205
US

IV. Provider business mailing address

3246 ERNEST ST
JACKSONVILLE FL
32205
US

V. Phone/Fax

Practice location:
  • Phone: 904-365-1617
  • Fax:
Mailing address:
  • Phone: 904-365-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: EARL TODD THOMPSON
Title or Position: OWNER
Credential: CNA
Phone: 904-365-1617