Provider Demographics
NPI:1710605134
Name:LAWSON BRAND ENTERPRISE INC
Entity Type:Organization
Organization Name:LAWSON BRAND ENTERPRISE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEELON
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-515-8519
Mailing Address - Street 1:5369 WHITE DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-6362
Mailing Address - Country:US
Mailing Address - Phone:901-406-9647
Mailing Address - Fax:
Practice Address - Street 1:5369 WHITE DIAMOND ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-6362
Practice Address - Country:US
Practice Address - Phone:901-406-9647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1306572540OtherNPI