Provider Demographics
NPI:1851844633
Name:MED TRANSPORT MEMPHIS, LLC
Entity Type:Organization
Organization Name:MED TRANSPORT MEMPHIS, LLC
Other - Org Name:MED TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARONESE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-484-8128
Mailing Address - Street 1:5100 POPLAR AVE STE 2720
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38137-4000
Mailing Address - Country:US
Mailing Address - Phone:615-484-8128
Mailing Address - Fax:
Practice Address - Street 1:5100 POPLAR AVE STE 2720
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-4000
Practice Address - Country:US
Practice Address - Phone:615-484-8128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
TN011073416L0300X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport