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General NPI Number Information
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NPI Number | 1790503449
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Entity Type | Organization
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Legal Business Name | J5 TRANSPORTATION LLC
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 9075 BROOKHOLLOW DR
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8311
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Country | US
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Telephone | 901-828-0477
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 HACKS CROSS RD STE 102-320
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City | MEMPHIS
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State | TN
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Zip | 38125-2367
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. CORETTA CANNON JONES
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Credential |
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Telephone | 901-828-0477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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