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Organization

BID TRANSPORTATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMIKA LATRIC DOUGLAS (OWNER/MANAGER)
(423) 322-6809
Entity
Organization

Contact information

Practice address
168 COUNTY ROAD 730, RICEVILLE, TN 37370-5725
(423) 322-6809
Mailing address
114 STUART RD NE, CLEVELAND, TN 37312-4803
(423) 322-6809

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0043206
TN

Other

Enumeration date
01/21/2009
Last updated
02/11/2009
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