Organization
GWC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C O WRIGHT (AUTHORIZED OFFICIAL)
(901) 474-4819
Entity
Organization
Contact information
Practice address
836 E EH CRUMP BLVD, MEMPHIS, TN 38126-3602
(901) 486-5603
(901) 578-3209
Mailing address
1809 BENNING ST, MEMPHIS, TN 38106-6247
(901) 474-4819
(901) 578-3209
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
109002406
TN
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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