Provider Demographics
NPI:1366999039
Name:METRO TRANSIT
Entity type:Organization
Organization Name:METRO TRANSIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-209-4969
Mailing Address - Street 1:2600 POPLAR AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3851
Mailing Address - Country:US
Mailing Address - Phone:901-209-4969
Mailing Address - Fax:901-290-2741
Practice Address - Street 1:2600 POPLAR AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3851
Practice Address - Country:US
Practice Address - Phone:901-209-4969
Practice Address - Fax:901-290-2741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)