Organization
BLUE ODYSSEY TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY TERRELL WADDELL EMT-IV (PARTNER)
(901) 219-4193
Entity
Organization
Contact information
Practice address
7634 KIOWA ST, APT. 1, MILLINGTON, TN 38053-3212
(901) 219-4193
Mailing address
7634 KIOWA ST, APT. 1, MILLINGTON, TN 38053-3212
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
097843376
TN
347C00000X
Private Vehicle
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Other
Enumeration date
07/27/2009
Last updated
08/08/2009
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