Healthcare Provider Details

I. General information

NPI: 1629607122
Provider Name (Legal Business Name): WORLES ON WHEELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 03/06/2021
Certification Date: 03/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 BALTIC ST
MEMPHIS TN
38112-2401
US

IV. Provider business mailing address

687 BALTIC ST
MEMPHIS TN
38112-2401
US

V. Phone/Fax

Practice location:
  • Phone: 901-864-3301
  • Fax:
Mailing address:
  • Phone: 901-864-3301
  • 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: MISS TRACY JO WORLES
Title or Position: OWNER
Credential:
Phone: 901-864-3301