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General NPI Number Information
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NPI Number | 1538307079
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Entity Type | Organization
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Legal Business Name | BID TRANSPORTATION
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 168 COUNTY ROAD 730
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City | RICEVILLE
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State | TN
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Zip | 37370-5725
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Country | US
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Telephone | 423-322-6809
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Fax |
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Provider Business Mailing Address
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Address Line | 114 STUART RD NE
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City | CLEVELAND
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State | TN
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Zip | 37312-4803
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Country | US
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Telephone | 423-322-6809
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TAMIKA LATRIC DOUGLAS
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Credential |
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Telephone | 423-322-6809
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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 | 0043206
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License Number State | TN
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