# TRANSFORMATION MEDICAL SERVICES, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689942682
- **Authorized official:** DR. ADDISON REEDE TARR D.O. (PRESIDENT AND CEO)
- **Authorized official phone:** (714) 225-8665

## Contact information

- **Practice address:** 21415 CIVIC CENTER DR, SUITE 111, SOUTHFIELD, MI 48076-3909
- **Practice address phone:** (248) 356-1111
- **Mailing address:** 21415 CIVIC CENTER DR, SUITE 111, SOUTHFIELD, MI 48076-3909
- **Mailing address phone:** (248) 356-1111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 5101015861 | MI | — |
| 207QA0505X | Adult Medicine Physician | 5101015861 | MI | Yes |

## Other

- **Enumeration date:** 12/05/2011
- **Last updated:** 12/05/2011