Provider Demographics
NPI:1770297517
Name:SURGE MEDICAL
Entity type:Organization
Organization Name:SURGE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARKEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:901-283-0713
Mailing Address - Street 1:2506 MOUNT MORIAH RD STE B458
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-1511
Mailing Address - Country:US
Mailing Address - Phone:901-288-5926
Mailing Address - Fax:
Practice Address - Street 1:2506 MOUNT MORIAH RD STE B458
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-1511
Practice Address - Country:US
Practice Address - Phone:901-288-5926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance