Healthcare Provider Details

I. General information

NPI: 1659879252
Provider Name (Legal Business Name): HUMMINGBIRD TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 STONEWALL
MEMPHIS TN
38108-3810
US

IV. Provider business mailing address

1305 STONEWALL ST
MEMPHIS TN
38108-1045
US

V. Phone/Fax

Practice location:
  • Phone: 901-596-4050
  • Fax:
Mailing address:
  • Phone: 901-596-4050
  • 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: MR. MELVIN RICE JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 901-596-4050