Provider Demographics
NPI:1760466627
Name:MED-TRANS OF TENNESSEE INC
Entity Type:Organization
Organization Name:MED-TRANS OF TENNESSEE INC
Other - Org Name:MED TRANS EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-745-3132
Mailing Address - Street 1:PO BOX 854
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0854
Mailing Address - Country:US
Mailing Address - Phone:423-745-0467
Mailing Address - Fax:423-744-3500
Practice Address - Street 1:5465 W US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-8169
Practice Address - Country:US
Practice Address - Phone:828-835-9997
Practice Address - Fax:828-835-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0201244341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00872671AMedicaid
GA4406608Medicaid
NC2783149Medicare ID - Type Unspecified