Provider Demographics
NPI:1003365032
Name:MIDDLE TENNESSEE TAXI
Entity Type:Organization
Organization Name:MIDDLE TENNESSEE TAXI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-543-0587
Mailing Address - Street 1:11661 BRADYVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:READYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37149-4517
Mailing Address - Country:US
Mailing Address - Phone:615-543-0587
Mailing Address - Fax:
Practice Address - Street 1:1018 SEALS WAY STE B
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4938
Practice Address - Country:US
Practice Address - Phone:615-543-0587
Practice Address - Fax:615-907-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi