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General NPI Number Information
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NPI Number | 1669184537
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Entity Type | Organization
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Legal Business Name | MERCY NON EMERGENCY MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 3080 W HIGHWAY 287 BYP
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City | WAXAHACHIE
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State | TX
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Zip | 75167-5000
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Country | US
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Telephone | 817-781-6512
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Fax |
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Provider Business Mailing Address
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Address Line | 3080 W HIGHWAY 287 BYP
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City | WAXAHACHIE
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State | TX
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Zip | 75167-5000
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Country | US
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Telephone | 817-781-6512
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Fax |
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Authorized Official
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Title or Position | CREDENTIAL MGR
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Name | TRALICA CLEWIS
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Credential |
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Telephone | 469-586-7643
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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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Taxonomy #2
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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