Healthcare Provider Details

I. General information

NPI: 1003365032
Provider Name (Legal Business Name): MIDDLE TENNESSEE TAXI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 10/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 SEALS WAY STE B
MURFREESBORO TN
37129-4938
US

IV. Provider business mailing address

11661 BRADYVILLE PIKE
READYVILLE TN
37149-4517
US

V. Phone/Fax

Practice location:
  • Phone: 615-543-0587
  • Fax: 615-907-7200
Mailing address:
  • Phone: 615-543-0587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: JOHNNY KYLE BAXTER
Title or Position: OWNER
Credential:
Phone: 615-543-0587