Organization
PURE TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYWASKA EWIN (OWNER)
(615) 310-0008
Entity
Organization
Contact information
Practice address
166 DELVIN DR, ANTIOCH, TN 37013-4032
(615) 310-0008
Mailing address
166 DELVIN DR, ANTIOCH, TN 37013-4032
(615) 310-0008
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023722709
NON MEDICAL TRANSPORTATION
TN
Enumeration date
02/22/2023
Last updated
02/22/2023
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