Puckett Med Van LLC
Non-emergency Medical Transport (VAN) in East Ridge, TN. Organization (NPI-2).
NPI number1487080149
StatusActive
Last updated in NPPESAug 9, 2023
Details
- NPI
- 1487080149
- Entity type
- Organization (NPI-2)
- Legal business name
- Puckett Med Van LLC
- Organization subpart
- No
- Enumeration date
- Sep 25, 2013
- Certification date
- Aug 9, 2023
- Last updated
- Aug 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 343900000X | Non-emergency Medical Transport (VAN) | – | – | Yes |
Practice location
5603 Ringgold RoadEast Ridge, TN 37412
Phone 423-894-4407 · Fax 770-943-5150
Mailing address
3760 Tramore Pointe PkwyAustell, GA 30106
Phone 770-222-5045 · Fax 770-943-5150
Authorized official
Robert A Jewell
Chief Revenue Integration Officer
8445974911
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