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General NPI Number Information
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NPI Number | 1629207527
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Entity Type | Organization
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Legal Business Name | DAVCO MEDICAL TRANSPORT INC
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 6952 STOUT RD
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City | MEMPHIS
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State | TN
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Zip | 38119-8525
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Country | US
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Telephone | 901-690-8999
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Fax | 901-328-5677
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Provider Business Mailing Address
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Address Line | PO BOX 382992
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City | GERMANTOWN
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State | TN
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Zip | 38183-2992
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Country | US
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Telephone | 901-690-8999
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Fax | 901-328-5677
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Authorized Official
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Title or Position | PRESIDENT
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Name | CONTESIA DAVIDSON
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Credential |
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Telephone | 901-690-8999
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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 | 74097537
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 74097537
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License Number State | TN
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