Provider Demographics
NPI:1821222944
Name:COURTESY MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:COURTESY MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-456-5412
Mailing Address - Street 1:205 E RICKERT AVE
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1333
Mailing Address - Country:US
Mailing Address - Phone:615-456-5412
Mailing Address - Fax:615-740-9221
Practice Address - Street 1:205 E RICKERT AVE
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1333
Practice Address - Country:US
Practice Address - Phone:615-456-5412
Practice Address - Fax:615-740-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20035343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)