Healthcare Provider Details

I. General information

NPI: 1376538603
Provider Name (Legal Business Name): MED-CARE AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 06/25/2024
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 RALEIGH LAGRANGE
MEMPHIS TN
38134
US

IV. Provider business mailing address

5275 RALEIGH LAGRANGE
MEMPHIS TN
38134
US

V. Phone/Fax

Practice location:
  • Phone: 901-685-2212
  • Fax:
Mailing address:
  • Phone: 901-685-2212
  • 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 Number9953
License Number StateTN

VIII. Authorized Official

Name: JAKE FARLEY
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 901-282-9079