Provider Demographics
NPI:1205190048
Name:METRO MEDICAL TRANSPORTATION INC.
Entity Type:Organization
Organization Name:METRO MEDICAL TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:901-232-0743
Mailing Address - Street 1:1101 CHAMBLISS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6330
Mailing Address - Country:US
Mailing Address - Phone:901-232-0743
Mailing Address - Fax:901-396-3603
Practice Address - Street 1:1101 CHAMBLISS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6330
Practice Address - Country:US
Practice Address - Phone:901-232-0743
Practice Address - Fax:901-396-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN084963950343900000X
MS800032369343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)