Provider Demographics
NPI:1912030131
Name:SOUTH CENTRAL TN DEVELOPMENT DISTRICT
Entity Type:Organization
Organization Name:SOUTH CENTRAL TN DEVELOPMENT DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-490-5892
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38402-1346
Mailing Address - Country:US
Mailing Address - Phone:931-490-5892
Mailing Address - Fax:931-381-4403
Practice Address - Street 1:815 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3307
Practice Address - Country:US
Practice Address - Phone:931-490-5892
Practice Address - Fax:931-381-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)