Provider Demographics
NPI:1720411226
Name:LOVE AN CARETRANSPORTATION
Entity Type:Organization
Organization Name:LOVE AN CARETRANSPORTATION
Other - Org Name:L.V
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:W.
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:061695346
Authorized Official - Phone:901-297-9041
Mailing Address - Street 1:1081 COURT AVE APT 734C
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2181
Mailing Address - Country:US
Mailing Address - Phone:901-297-9041
Mailing Address - Fax:
Practice Address - Street 1:1081 COURT AVE # 734C
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2181
Practice Address - Country:US
Practice Address - Phone:901-297-9041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVE AN CARETRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========Medicaid