Provider Demographics
NPI:1275336828
Name:OKHIRIA, EROMOSELE
Entity type:Individual
Prefix:
First Name:EROMOSELE
Middle Name:
Last Name:OKHIRIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 LEXINGTON MANOR LN
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-8016
Mailing Address - Country:US
Mailing Address - Phone:901-292-8735
Mailing Address - Fax:
Practice Address - Street 1:510 LEXINGTON MANOR LN
Practice Address - Street 2:
Practice Address - City:EADS
Practice Address - State:TN
Practice Address - Zip Code:38028-8016
Practice Address - Country:US
Practice Address - Phone:901-292-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)