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General NPI Number Information
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NPI Number | 1154320687
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Entity Type | Organization
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Legal Business Name | SULLIVAN COUNTY EMS
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 3193 HIGHWAY 126
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City | BLOUNTVILLE
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State | TN
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Zip | 37617
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Country | US
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Telephone | 423-323-6471
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Fax | 423-279-2813
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | BLOUNTVILLE
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State | TN
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Zip | 37617
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Country | US
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Telephone | 423-323-6474
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Fax | 423-279-2813
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Authorized Official
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Title or Position | CHIEF
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Name | JIM PERRY
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Credential |
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Telephone | 423-323-6474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | EMS0000008201
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | TN
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