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General NPI Number Information
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NPI Number | 1417487786
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Entity Type | Organization
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Legal Business Name | FIRSTCARE AMBULANCE SERVICE, LLC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 444 BELL RD
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City | NASHVILLE
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State | TN
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Zip | 37217-3823
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Country | US
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Telephone | 901-833-2830
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Fax | 901-795-7025
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Provider Business Mailing Address
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Address Line | 3180 MILLINGTON ROAD
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City | MEMPHIS
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State | TN
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Zip | 38127
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GORDON WYNN
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Credential |
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Telephone | 901-833-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 10218
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License Number State | TN
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