Healthcare Provider Details

I. General information

NPI: 1093251845
Provider Name (Legal Business Name): RELIANT MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 10/07/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 NORTHTOWN DR SUITE 130
JACKSON MS
39211-3047
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 601-487-8993
  • Fax:
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES W. (TRIPP) FRANCIS III
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 601-573-0075