Healthcare Provider Details

I. General information

NPI: 1982885190
Provider Name (Legal Business Name): MED LIFTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S HOLTZCLAW AVE
CHATTANOOGA TN
37404-4803
US

IV. Provider business mailing address

1700 S HOLTZCLAW AVE
CHATTANOOGA TN
37404-4803
US

V. Phone/Fax

Practice location:
  • Phone: 423-629-2889
  • Fax: 423-629-0898
Mailing address:
  • Phone: 423-629-2889
  • Fax: 423-629-0898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number0507552
License Number StateTN

VIII. Authorized Official

Name: KYLE DAVID WILLIAMS
Title or Position: OWNER
Credential:
Phone: 426-629-2889