Healthcare Provider Details

I. General information

NPI: 1588640742
Provider Name (Legal Business Name): HANCOCK COUNTY AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 MAIN STREET
SNEEDVILLE TN
37869
US

IV. Provider business mailing address

PO BOX 409 1517 MAIN ST
SNEEDVILLE TN
37869
US

V. Phone/Fax

Practice location:
  • Phone: 423-733-4454
  • Fax: 423-733-4454
Mailing address:
  • Phone: 423-733-4454
  • Fax: 423-733-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberEMS0000003401
License Number StateTN

VIII. Authorized Official

Name: MR. THOMAS J HARRISON V
Title or Position: COUNTY MAYOR
Credential:
Phone: 423-733-4341