Provider Demographics
NPI:1093324337
Name:RELIABLE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:RELIABLE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:BRESHALIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-888-1250
Mailing Address - Street 1:PO BOX 3118
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-0118
Mailing Address - Country:US
Mailing Address - Phone:423-888-1250
Mailing Address - Fax:423-497-5718
Practice Address - Street 1:1918 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-5319
Practice Address - Country:US
Practice Address - Phone:423-888-1250
Practice Address - Fax:423-497-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport
No347E00000XTransportation ServicesTransportation Broker