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General NPI Number Information
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NPI Number | 1407080922
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Entity Type | Organization
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Legal Business Name | EXPRESS TRANSPORTERS OF THE MID-SOUTH LLC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 3755 CHERRY RD
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City | MEMPHIS
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State | TN
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Zip | 38118-6320
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Country | US
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Telephone | 901-531-6590
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Fax | 901-542-0622
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Provider Business Mailing Address
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Address Line | 3755 CHERRY RD
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City | MEMPHIS
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State | TN
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Zip | 38118-6320
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Country | US
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Telephone | 901-531-6590
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Fax | 901-542-0622
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Authorized Official
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Title or Position | PARTNER
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Name | MR. ROBERT GRAHAM MCBRIDE
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Credential |
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Telephone | 901-531-6590
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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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