Healthcare Provider Details

I. General information

NPI: 1093755514
Provider Name (Legal Business Name): KNOX COUNTY EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 N 10TH ST
VINCENNES IN
47591-3136
US

IV. Provider business mailing address

906 N 10TH ST
VINCENNES IN
47591-3136
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-7757
  • Fax: 812-882-0989
Mailing address:
  • Phone: 812-882-7757
  • Fax: 812-882-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0071
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0071
License Number StateIN

VIII. Authorized Official

Name: MRS. CHRISTA JANE MCCLURE
Title or Position: BILLING MANAGER
Credential:
Phone: 812-882-7757