Provider Demographics
NPI:1174015283
Name:MTS LIVE LLC
Entity Type:Organization
Organization Name:MTS LIVE LLC
Other - Org Name:MTS LIVE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:901-512-8061
Mailing Address - Street 1:122 S STARKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MS
Mailing Address - Zip Code:38851-2635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 S STARKVILLE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MS
Practice Address - Zip Code:38851-2635
Practice Address - Country:US
Practice Address - Phone:662-456-0870
Practice Address - Fax:662-456-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
343800000XOtherSECURED MEDICAL TRANSPORT (VAN)
347C00000XOtherPRIVATE VEHICLE
343900000XOtherNON-EMERGENCY TRANSPORT (VAN)