Healthcare Provider Details

I. General information

NPI: 1285082438
Provider Name (Legal Business Name): CDATRANSPORTATIONSERVICESLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2016
Last Update Date: 05/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 FOX VALLEY DR
MEMPHIS TN
38127-2626
US

IV. Provider business mailing address

453 FOX VALLEY DR
MEMPHIS TN
38127-2626
US

V. Phone/Fax

Practice location:
  • Phone: 901-652-5290
  • Fax:
Mailing address:
  • Phone: 901-652-5290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHESTER ARTHUR ASHFORD JR.
Title or Position: CFO
Credential:
Phone: 901-652-5290