Healthcare Provider Details

I. General information

NPI: 1104457100
Provider Name (Legal Business Name): URIDEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 MILLIGAN LN
JOHNSON CITY TN
37601-9204
US

IV. Provider business mailing address

36 MILLIGAN LN
JOHNSON CITY TN
37601-9204
US

V. Phone/Fax

Practice location:
  • Phone: 423-617-4625
  • Fax:
Mailing address:
  • Phone: 423-617-4625
  • Fax:

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 Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA R JENKINS
Title or Position: CEO
Credential: PARAMEDIC
Phone: 844-487-4339