Organization Name: | BLUE ODYSSEY TRANSPORTATION |
NPI Number: | 1255562153 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY TERRELL WADDELL (PARTNER) |
Mailing Address: | 7634 Kiowa St Apt. 1 Millington |
State: | TN US |
Postal Code: | 380533212 |
Phone Number: | 9012194193 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2009 |
NPI Last Update Date: | 08/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |