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General NPI Number Information
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NPI Number | 1326019480
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Entity Type | Organization
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Legal Business Name | OVERTON COUNTY AMBULANCE SERVICE
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 5900 BRADFORD HICKS DRIVE
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City | LIVINGSTON
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State | TN
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Zip | 38570-2236
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Country | US
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Telephone | 931-823-6402
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Fax | 931-823-7739
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Provider Business Mailing Address
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Address Line | 5900 BRADFORD HICKS DRIVE
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City | LIVINGSTON
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State | TN
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Zip | 38570-2236
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Country | US
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Telephone | 931-823-6402
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Fax | 931-823-7739
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Authorized Official
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Title or Position | DIRECTOR
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Name | JIM MORGAN
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Credential |
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Telephone | 931-823-6402
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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 | EMS0000006702
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License Number State | TN
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