Organization
BLUE HERON TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MANOR (OWNER)
(615) 588-6769
Entity
Organization
Contact information
Practice address
177 SPURLOCK LN, HICKMAN, TN 38567-5112
(615) 548-2415
(615) 548-2415
Mailing address
PO BOX 107, HICKMAN, TN 38567-0107
(615) 588-6769
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0009023
TN
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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