Healthcare Provider Details

I. General information

NPI: 1689217416
Provider Name (Legal Business Name): MERCY AMBULANCE OF EVANSVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S MAIN ST STE 4
HARLAN KY
40831-1909
US

IV. Provider business mailing address

PO BOX 100217
ATLANTA GA
30384-0217
US

V. Phone/Fax

Practice location:
  • Phone: 606-573-2721
  • Fax:
Mailing address:
  • Phone: 800-913-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIAN SCOTT TIERNEY
Title or Position: EVP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 833-703-2294