Provider Demographics
NPI:1700040342
Name:PROMPT TRANSPORTATION
Entity Type:Organization
Organization Name:PROMPT TRANSPORTATION
Other - Org Name:PROMPT TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:SR
Authorized Official - Credentials:TRANSPORTATION VENDO
Authorized Official - Phone:901-590-5027
Mailing Address - Street 1:2331 HUBBARD AVE.
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38108-2360
Mailing Address - Country:US
Mailing Address - Phone:901-590-5027
Mailing Address - Fax:901-725-6836
Practice Address - Street 1:2331 HUBBARD AVE.
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38108-2360
Practice Address - Country:US
Practice Address - Phone:901-590-5027
Practice Address - Fax:901-725-6836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMPT TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN107005774343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT000253Medicaid
TN8671Medicare PIN