Provider Demographics
NPI:1326681594
Name:CHC901 LLC
Entity Type:Organization
Organization Name:CHC901 LLC
Other - Org Name:COMMUNITY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-275-5131
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:TN
Mailing Address - Zip Code:38014-0250
Mailing Address - Country:US
Mailing Address - Phone:901-425-9500
Mailing Address - Fax:
Practice Address - Street 1:2565 HORIZON LAKE DR STE 110
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-8113
Practice Address - Country:US
Practice Address - Phone:901-321-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416A0800XTransportation ServicesAmbulanceAir Transport
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)