Provider Demographics
NPI:1194170704
Name:NANA POP-INS MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:NANA POP-INS MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-964-2233
Mailing Address - Street 1:P.O. BOX 4702
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831
Mailing Address - Country:US
Mailing Address - Phone:865-964-2233
Mailing Address - Fax:
Practice Address - Street 1:136 S ILLINOIS AVE STE 214
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6220
Practice Address - Country:US
Practice Address - Phone:865-964-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)