Provider Demographics
NPI:1124204631
Name:CANAAN CARRIER SERVICE
Entity Type:Organization
Organization Name:CANAAN CARRIER SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-977-3649
Mailing Address - Street 1:816 SHELBY AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3734
Mailing Address - Country:US
Mailing Address - Phone:615-227-1100
Mailing Address - Fax:615-226-1862
Practice Address - Street 1:816 SHELBY AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3734
Practice Address - Country:US
Practice Address - Phone:615-977-3649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNT000239343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)