MEDICARE: GOODMANS STAY READY TRANSIT LLC

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)

General Provider Information

NPI Number	:	1598513806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOODMANS STAY READY TRANSIT LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 2746
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37133
Country	:	US
Telephone Number	:	615-473-4238
Fax Number	:

Provider Business Practice Location Address
First Line	:	2206 HAVEN DR.
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130
Country	:	US
Telephone Number	:	615-473-4238
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LAWRENCE GOODMAN III
Credential	:
Telephone Number	:	615-473-4238

Provider Enumeration Date	:	05/10/2024
Last Update Date	:	05/10/2024

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