Provider Demographics
NPI:1043940935
Name:MDP NON-EMERGENCY TRANSPORTATION SC
Entity Type:Organization
Organization Name:MDP NON-EMERGENCY TRANSPORTATION SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-520-5681
Mailing Address - Street 1:39 E MCKELLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-2324
Mailing Address - Country:US
Mailing Address - Phone:901-520-5681
Mailing Address - Fax:
Practice Address - Street 1:39 E MCKELLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-2324
Practice Address - Country:US
Practice Address - Phone:901-520-5681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle