Healthcare Provider Details
I. General information
NPI: 1568191815
Provider Name (Legal Business Name): RBJ SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7443 KEYNON CV
MEMPHIS TN
38125-2737
US
IV. Provider business mailing address
7443 KEYNON CV
MEMPHIS TN
38125-2737
US
V. Phone/Fax
- Phone: 754-264-8521
- Fax:
- Phone: 754-264-8521
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICKY
JACKSON
Title or Position: OWNER
Credential:
Phone: 754-264-8521