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General NPI Number Information
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NPI Number | 1013745082
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Entity Type | Organization
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Legal Business Name | FROG SERVICES LLC.
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 9127 CORPORATE DR
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City | SOUTHAVEN
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State | MS
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Zip | 38671-1243
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Country | US
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Telephone | 901-490-5894
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 CORPORATE DR
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City | SOUTHAVEN
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State | MS
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Zip | 38671-1243
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Country | US
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Telephone | 901-490-5894
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD L SMITH SR.
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Credential |
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Telephone | 901-490-5894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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