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General NPI Number Information
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NPI Number | 1518948959
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Entity Type | Organization
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Legal Business Name | COUNTY OF WHITE
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 1 E BOCKMAN WAY WHITE CO. COURTHOUSE RM # 204
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City | SPARTA
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State | TN
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Zip | 38583-2049
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Country | US
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Telephone | 931-836-3216
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Fax | 931-836-3343
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Provider Business Mailing Address
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Address Line | 1 E BOCKMAN WAY RM 204
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City | SPARTA
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State | TN
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Zip | 38583-2049
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Country | US
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Telephone | 931-836-3216
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Fax | 931-836-3343
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | CHAD MARCUM
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Credential |
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Telephone | 931-836-3216
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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 | EMS0000009302
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License Number State | TN
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