Healthcare Provider Details

I. General information

NPI: 1063837946
Provider Name (Legal Business Name): TOLLIVER-SCOTT & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 KENNY ROAD
MARTIN TN
38237
US

IV. Provider business mailing address

113 KENNY ROAD
MARTIN TN
38237
US

V. Phone/Fax

Practice location:
  • Phone: 731-587-3797
  • Fax: 731-587-3798
Mailing address:
  • Phone: 731-587-3797
  • Fax: 731-587-3798

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 Number
License Number State

VIII. Authorized Official

Name: BRENDA TOLLIVER SCOTT
Title or Position: CEO
Credential:
Phone: 731-332-0781