Healthcare Provider Details

I. General information

NPI: 1770369357
Provider Name (Legal Business Name): CAUGHRON TRANSPORT SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6527 CANNON RD
MARYVILLE TN
37801-1429
US

IV. Provider business mailing address

6527 CANNON RD
MARYVILLE TN
37801-1429
US

V. Phone/Fax

Practice location:
  • Phone: 888-233-4760
  • Fax:
Mailing address:
  • Phone: 888-233-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES DELANO CAUGHRON II
Title or Position: OWNER
Credential:
Phone: 888-233-4760