Healthcare Provider Details

I. General information

NPI: 1508990565
Provider Name (Legal Business Name): RELIABLE TRANSPORTATION OF LIVINGSTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9659 GRAYS LAKE CV
CORDOVA TN
38018-7770
US

IV. Provider business mailing address

9659 GRAYS LAKE CV
CORDOVA TN
38018-7770
US

V. Phone/Fax

Practice location:
  • Phone: 931-239-2112
  • Fax: 901-590-3953
Mailing address:
  • Phone: 931-239-2112
  • Fax: 901-590-3953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number002961
License Number StateTN

VIII. Authorized Official

Name: MRS. LIZ A WESSON
Title or Position: PRESIDENT
Credential:
Phone: 931-823-2296