Healthcare Provider Details

I. General information

NPI: 1427415694
Provider Name (Legal Business Name): METRO TRANSPORTATION SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6309 ALTHORP CV
LAKELAND TN
38002-7005
US

IV. Provider business mailing address

6309 ALTHORP CV
LAKELAND TN
38002-7005
US

V. Phone/Fax

Practice location:
  • Phone: 901-487-9653
  • Fax: 901-829-7766
Mailing address:
  • Phone: 901-487-9653
  • Fax: 901-829-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number113003348
License Number StateTN

VIII. Authorized Official

Name: MISS TEQUA MIMS
Title or Position: CEO
Credential:
Phone: 901-487-9653