Healthcare Provider Details

I. General information

NPI: 1891731444
Provider Name (Legal Business Name): JEFFERSON COUNTY EMERGENCY MEDICAL SERV.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 INDUSTRIAL PARK RD
DANDRIDGE TN
37725-4701
US

IV. Provider business mailing address

931 INDUSTRIAL PARK RD PO BOX 1206
DANDRIDGE TN
37725-4701
US

V. Phone/Fax

Practice location:
  • Phone: 865-397-7228
  • Fax: 865-397-4687
Mailing address:
  • Phone: 865-397-7228
  • Fax: 865-397-4687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS0000004501
License Number StateTN

VIII. Authorized Official

Name: MR. JOESPH B. PHILLIPS JR.
Title or Position: DIRECTOR
Credential:
Phone: 865-397-7228