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General NPI Number Information
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NPI Number | 1154565505
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Entity Type | Organization
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Legal Business Name | PHILLIPS COUNTY TRANSPORTATION
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 05/05/2009
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Provider Practice Location Address
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Address Line | 1444 TRAFALGAR CV
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City | SOUTHAVEN
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State | MS
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Zip | 38671-8988
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Country | US
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Telephone | 901-489-3890
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Fax | 662-536-3368
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Provider Business Mailing Address
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Address Line | 4440 RYAN ST
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City | MEMPHIS
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State | TN
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Zip | 38127-2829
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Country | US
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Telephone | 901-267-3939
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Fax | 662-536-3368
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Authorized Official
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Title or Position | OWNER
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Name | MR. FELIX R AKINBOBOYE
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Credential | TRANSPOTATION
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Telephone | 901-489-3890
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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 | TN
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