MEDICARE: RELIABLE MEDICAL TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	347E00000X	Transportation Broker
2	3416L0300X	Land Ambulance
3	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1093324337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIABLE MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	PO BOX 3118
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37404-0118
Country	:	US
Telephone Number	:	423-888-1250
Fax Number	:	423-497-5718

Provider Business Practice Location Address
First Line	:	1918 RANDOLPH ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37404-5319
Country	:	US
Telephone Number	:	423-888-1250
Fax Number	:	423-497-5718

Authorized Official
Title or Position	:	OWNER/MANGER
Name	:	BRESHALIA M JACKSON
Credential	:
Telephone Number	:	423-888-1250

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	07/22/2020

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Directions to “RELIABLE MEDICAL TRANSPORTATION ” Practice Location

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