Healthcare Provider Details

I. General information

NPI: 1710981238
Provider Name (Legal Business Name): STEWART COUNTY EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 SPRING ST
DOVER TN
37058-3208
US

IV. Provider business mailing address

PO BOX 487
DOVER TN
37058-0487
US

V. Phone/Fax

Practice location:
  • Phone: 931-232-3093
  • Fax: 931-232-4859
Mailing address:
  • Phone: 931-232-3093
  • Fax: 931-232-4859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberEMS00000008101
License Number StateTN

VIII. Authorized Official

Name: ROBYN WATKINS
Title or Position: ACCOUNTS BILLING MANAGER
Credential:
Phone: 931-232-1190