Healthcare Provider Details

I. General information

NPI: 1740016328
Provider Name (Legal Business Name): COVENANT HEALTH EMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 FORT SUMMIT WAY FL 3
KNOXVILLE TN
37915-2146
US

IV. Provider business mailing address

550 FORT SUMMIT WAY FL 3
KNOXVILLE TN
37915-2146
US

V. Phone/Fax

Practice location:
  • Phone: 865-331-0014
  • Fax:
Mailing address:
  • Phone: 865-331-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DANNY L MCCREARY
Title or Position: DIRECTOR OF EMS
Credential:
Phone: 865-617-9328