MEDICARE: 901TRU CARE TRANSPORT

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1700596012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	901TRU CARE TRANSPORT

Provider Business Mailing Address
First Line	:	7119 BROOK MILL CV
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-4193
Country	:	US
Telephone Number	:	901-334-7116
Fax Number	:

Provider Business Practice Location Address
First Line	:	7119 BROOK MILL CV
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-4193
Country	:	US
Telephone Number	:	901-334-7116
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAMELA GREENWOOD
Credential	:
Telephone Number	:	901-334-7116

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	11/28/2022

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