Provider Demographics
NPI:1063898088
Name:SELSON ENTERPRISE, INC
Entity type:Organization
Organization Name:SELSON ENTERPRISE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-222-3824
Mailing Address - Street 1:2817 W END AVE
Mailing Address - Street 2:SUITE 126316
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1453
Mailing Address - Country:US
Mailing Address - Phone:470-222-3824
Mailing Address - Fax:
Practice Address - Street 1:2817 W END AVE
Practice Address - Street 2:SUITE 126316
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1453
Practice Address - Country:US
Practice Address - Phone:470-222-3824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNUSDOT 2728028343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)