Provider Demographics
NPI:1114387594
Name:DRIVEN TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:DRIVEN TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:901-335-5081
Mailing Address - Street 1:1194 MACON HALL RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6587
Mailing Address - Country:US
Mailing Address - Phone:901-275-4022
Mailing Address - Fax:
Practice Address - Street 1:1194 MACON HALL RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6587
Practice Address - Country:US
Practice Address - Phone:901-275-4022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)