MEDICARE: TC EXPRESS

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)		MS

General Provider Information

NPI Number	:	1770076788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TC EXPRESS

Provider Business Mailing Address
First Line	:	2798 LAKE LOWNDES RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2798 LAKE LOWNDES RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9215
Country	:	US
Telephone Number	:	662-328-8294
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MARTHA DEGRAFFENRIED
Credential	:
Telephone Number	:	662-328-8294

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	06/13/2018

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Directions to “TC EXPRESS ” Practice Location

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