Healthcare Provider Details

I. General information

NPI: 1578812244
Provider Name (Legal Business Name): MEDICONE MEDICAL RESPONSE DELTA REGION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 RALEIGH LAGRANGE RD
MEMPHIS TN
38134-5605
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 270-744-9600
  • Fax: 270-744-0834
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JAMES REEVES
Title or Position: CEO
Credential: NREMT-P
Phone: 217-690-5672