Provider Demographics
NPI:1700604709
Name:GRACE NEMT LLC
Entity type:Organization
Organization Name:GRACE NEMT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASUROR
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TESFAGIORGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-810-5036
Mailing Address - Street 1:2201 MURFREESBORO PIKE STE A108
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3470
Mailing Address - Country:US
Mailing Address - Phone:615-645-9170
Mailing Address - Fax:
Practice Address - Street 1:2201 MURFREESBORO PIKE STE A108
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3470
Practice Address - Country:US
Practice Address - Phone:615-645-9170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)