Provider Demographics
NPI:1447532270
Name:MASONS AND DAUGHTER LLC
Entity type:Organization
Organization Name:MASONS AND DAUGHTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:423-704-8462
Mailing Address - Street 1:7 NORTH TUXEDO AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411
Mailing Address - Country:US
Mailing Address - Phone:423-531-4103
Mailing Address - Fax:423-468-4676
Practice Address - Street 1:7 NORTH TUXEDO AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:423-531-4103
Practice Address - Fax:423-468-4676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASON & DAUGHTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNIV5945A343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)