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General NPI Number Information
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NPI Number | 1063898088
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Entity Type | Organization
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Legal Business Name | SELSON ENTERPRISE, INC
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 2817 W END AVE SUITE 126316
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City | NASHVILLE
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State | TN
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Zip | 37203-1453
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Country | US
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Telephone | 470-222-3824
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 W END AVE SUITE 126316
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City | NASHVILLE
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State | TN
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Zip | 37203-1453
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Country | US
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Telephone | 470-222-3824
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | TONYA KILPATRICK
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Credential |
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Telephone | 470-222-3824
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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 | USDOT 2728028
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License Number State | TN
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