Organization
TRANS 2020
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAHED IKBARIEH (MEMBER)
(731) 431-1684
Entity
Organization
Contact information
Practice address
8541 MACON RD, CORDOVA, TN 38018-6101
(731) 431-1684
Mailing address
8541 MACON RD, CORDOVA, TN 38018-6101
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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