MEDICARE: SAFETY SENIOR TRANSPORTATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	125900500	TN

General Provider Information

NPI Number	:	1558873026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFETY SENIOR TRANSPORTATION

Provider Business Mailing Address
First Line	:	315 MIDWAY CIR
Second Line	:
City	:	MIDWAY
State	:	TN
Zip	:	37809-3709
Country	:	US
Telephone Number	:	423-329-7834
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 MIDWAY CIR
Second Line	:
City	:	MIDWAY
State	:	TN
Zip	:	37809-3709
Country	:	US
Telephone Number	:	423-329-7834
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DELLA HICKS
Credential	:
Telephone Number	:	423-329-7834

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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Directions to “SAFETY SENIOR TRANSPORTATION ” Practice Location

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