Provider Demographics
NPI:1649895004
Name:PTI TRANSPORT INC
Entity type:Organization
Organization Name:PTI TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:DEMETRICA
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-691-8574
Mailing Address - Street 1:3419 TYRON CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-2501
Mailing Address - Country:US
Mailing Address - Phone:901-691-8574
Mailing Address - Fax:
Practice Address - Street 1:4384 STAGE RD STE 204
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5762
Practice Address - Country:US
Practice Address - Phone:901-585-0952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACEFUL TRANSITIONS IN-HOME CARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)