=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851021554
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREFERRED CARRIER NEMT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2022
-----------------------------------------------------
Last Update Date | 09/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3922 YORKTOWN RD
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37416-2228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-280-2433
-----------------------------------------------------
Fax | 423-521-3792
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 19225
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37416-9225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-280-2433
-----------------------------------------------------
Fax | 423-521-3792
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO OWNER
-----------------------------------------------------
Name | CASSANDRA BARROW
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-280-2433
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------