Healthcare Provider Details

I. General information

NPI: 1437664232
Provider Name (Legal Business Name): TMDT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7062 HIGHWAY 64
OAKLAND TN
38060-3208
US

IV. Provider business mailing address

875 W. POPLAR,SUITE 23 - 129
COLLIERVILLE TN
38017-2513
US

V. Phone/Fax

Practice location:
  • Phone: 901-495-2323
  • Fax: 901-687-2105
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateTN

VIII. Authorized Official

Name: MRS. TESS DAVIDSON
Title or Position: PRESIDENT
Credential:
Phone: 901-495-2323