Provider Demographics
NPI:1154565505
Name:PHILLIPS COUNTY TRANSPORTATION
Entity type:Organization
Organization Name:PHILLIPS COUNTY TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:R
Authorized Official - Last Name:AKINBOBOYE
Authorized Official - Suffix:
Authorized Official - Credentials:TRANSPOTATION
Authorized Official - Phone:901-489-3890
Mailing Address - Street 1:4440 RYAN ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-2829
Mailing Address - Country:US
Mailing Address - Phone:901-267-3939
Mailing Address - Fax:662-536-3368
Practice Address - Street 1:1444 TRAFALGAR CV
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-8988
Practice Address - Country:US
Practice Address - Phone:901-489-3890
Practice Address - Fax:662-536-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)