Healthcare Provider Details

I. General information

NPI: 1043742802
Provider Name (Legal Business Name): EXPEDITED MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WILLIAM NORTHERN BLVD
TULLAHOMA TN
37388-4765
US

IV. Provider business mailing address

362 JESS FRAZIER LN
MANCHESTER TN
37355-4187
US

V. Phone/Fax

Practice location:
  • Phone: 931-308-9356
  • Fax: 931-691-9933
Mailing address:
  • Phone: 931-308-9356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number000896750
License Number StateTN

VIII. Authorized Official

Name: MR. JOHN MARSEE
Title or Position: PRESIDENT
Credential:
Phone: 931-308-9356