Provider Demographics
NPI:1598590275
Name:SOUTHERN CHARM CONCIERGE
Entity type:Organization
Organization Name:SOUTHERN CHARM CONCIERGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PONTOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-626-8423
Mailing Address - Street 1:135 HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1537
Mailing Address - Country:US
Mailing Address - Phone:931-626-8423
Mailing Address - Fax:
Practice Address - Street 1:6934 WELLSFORD LN
Practice Address - Street 2:
Practice Address - City:COLLEGE GROVE
Practice Address - State:TN
Practice Address - Zip Code:37046-1430
Practice Address - Country:US
Practice Address - Phone:931-626-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)