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General NPI Number Information
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NPI Number | 1841703097
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Entity Type | Organization
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Legal Business Name | TENNESSEE MEDIC LLC
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 325 PLUS PARK BLVD STE 208
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City | NASHVILLE
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State | TN
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Zip | 37217-1092
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Country | US
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Telephone | 615-870-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 325 PLUS PARK BLVD STE 208
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City | NASHVILLE
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State | TN
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Zip | 37217-1092
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Country | US
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Telephone | 615-870-2545
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELMOEIZ ELFAKI
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Credential |
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Telephone | 161-587-0254
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 203266
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License Number State | TN
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