Organization
CARE-A-VAN MEDICAL TRANSIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENJI JERMAINE WELLS (EXECUTIVE DIRECTOR)
(901) 857-5961
Entity
Organization
Contact information
Practice address
8331 BLUE RIDGE DR, SOUTHAVEN, MS 38672-6589
(901) 857-5961
Mailing address
8331 BLUE RIDGE DR, SOUTHAVEN, MS 38672-6589
(901) 857-5961
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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