Healthcare Provider Details

I. General information

NPI: 1447891908
Provider Name (Legal Business Name): LIG TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 10/12/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 HAZELWOOD RD
MEMPHIS TN
38109-3259
US

IV. Provider business mailing address

485 HAZELWOOD RD
MEMPHIS TN
38109-3259
US

V. Phone/Fax

Practice location:
  • Phone: 901-864-0283
  • Fax:
Mailing address:
  • Phone: 901-864-0283
  • 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: MS. LISA ISOM
Title or Position: OWNER
Credential:
Phone: 901-864-0283