Provider Demographics
NPI:1679030928
Name:MEDICAL TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:MEDICAL TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-440-6219
Mailing Address - Street 1:PO BOX 381047
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-1047
Mailing Address - Country:US
Mailing Address - Phone:901-440-6219
Mailing Address - Fax:901-507-8298
Practice Address - Street 1:2502 MOUNT MORIAH RD STE A120
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-7501
Practice Address - Country:US
Practice Address - Phone:901-440-6219
Practice Address - Fax:901-507-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNEMS0000010255OtherSTATE LICENSE