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General NPI Number Information
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NPI Number | 1992662795
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Entity Type | Organization
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Legal Business Name | CLM EXPRESS LLC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 15711 HIGHWAY 51
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City | OAKLAND
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State | MS
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Zip | 38948-2337
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Country | US
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Telephone | 662-699-0913
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Fax |
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Provider Business Mailing Address
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Address Line | 1231 SUNSET DR STE 187
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City | GRENADA
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State | MS
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Zip | 38901-4025
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Country | US
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Telephone | 662-299-0913
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EVONNE ROBERTS-TIDWELL
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Credential | LPN
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Telephone | 662-699-0913
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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 | 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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