Healthcare Provider Details

I. General information

NPI: 1437613775
Provider Name (Legal Business Name): DDS NON-EMERGENCY TRANSPORTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 DELANO AVE APT 21
MEMPHIS TN
38127-8605
US

IV. Provider business mailing address

1735 DELANO AVE APT 21
MEMPHIS TN
38127-8605
US

V. Phone/Fax

Practice location:
  • Phone: 901-725-9172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: GLENDA FAYE SEAY
Title or Position: OWNER
Credential:
Phone: 901-725-9172