Provider Demographics
NPI:1760054142
Name:UNIVERSAL SUPPORTIVE CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:UNIVERSAL SUPPORTIVE CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-729-6237
Mailing Address - Street 1:1840 PYRAMID PL STE 322
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38132-1703
Mailing Address - Country:US
Mailing Address - Phone:901-729-6237
Mailing Address - Fax:901-672-8520
Practice Address - Street 1:1840 PYRAMID PL STE 322
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38132-1703
Practice Address - Country:US
Practice Address - Phone:901-729-6237
Practice Address - Fax:901-672-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0OtherNONE MEDICAL TRANSPORTATION SERVICES