Provider Demographics
NPI:1104392661
Name:ABC'S OF LIFE, INC
Entity Type:Organization
Organization Name:ABC'S OF LIFE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:WHITTAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MBA
Authorized Official - Phone:619-289-1956
Mailing Address - Street 1:1779 KIRBY PKWY STE 1-151
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3666
Mailing Address - Country:US
Mailing Address - Phone:901-289-1956
Mailing Address - Fax:901-794-2838
Practice Address - Street 1:1779 KIRBY PKWY STE 1-151
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-3666
Practice Address - Country:US
Practice Address - Phone:901-289-1956
Practice Address - Fax:901-794-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)