Organization
OMNI MEDICAL TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LESTER LEON RUSSELL (DIRECTOR/OWNER)
(901) 679-5366
Entity
Organization
Contact information
Practice address
10111 CAMERON RIDGE TRL, CORDOVA, TN 38016-7184
(901) 679-5366
Mailing address
10111 CAMERON RIDGE TRL, CORDOVA, TN 38016-7184
(901) 679-5366
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
10179
TN
Other
Enumeration date
05/09/2014
Last updated
05/09/2014
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