Provider Demographics
NPI:1871938050
Name:EAST TENN. MEDICAL TRANS.
Entity type:Organization
Organization Name:EAST TENN. MEDICAL TRANS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-552-7142
Mailing Address - Street 1:3810 W ALLENS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-1776
Mailing Address - Country:US
Mailing Address - Phone:423-552-7142
Mailing Address - Fax:
Practice Address - Street 1:3810 W ALLENS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-1776
Practice Address - Country:US
Practice Address - Phone:423-552-7142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0473092343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)