Healthcare Provider Details

I. General information

NPI: 1013240670
Provider Name (Legal Business Name): METRO TRANSPORTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6309 ALTHORP COVE
LAKELAND TN
38002-7005
US

IV. Provider business mailing address

6309 ALTHORP COVE
LAKELAND TN
38002-7005
US

V. Phone/Fax

Practice location:
  • Phone: 901-829-4554
  • Fax: 901-829-7766
Mailing address:
  • Phone: 901-829-4554
  • Fax: 901-829-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KEISHA PICKETT JACKSON
Title or Position: OWNER
Credential:
Phone: 901-481-8979