MEDICARE: TIMELY TRANSPORTATION, 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	:	1992005151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMELY TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	1352 POPLAR ESTATES PKWY
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1538
Country	:	US
Telephone Number	:	901-340-7019
Fax Number	:	901-680-8271

Provider Business Practice Location Address
First Line	:	1352 POPLAR ESTATES PKWY
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1538
Country	:	US
Telephone Number	:	901-340-7019
Fax Number	:	901-680-8271

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN SANDERSON
Credential	:
Telephone Number	:	901-340-7019

Provider Enumeration Date	:	10/21/2010
Last Update Date	:	10/21/2010

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