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General NPI Number Information
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NPI Number | 1528721693
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Entity Type | Organization
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Legal Business Name | IKONIC EMS
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 11114 AMBIANCE WAY
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City | FRANKLIN
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State | TN
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Zip | 37067
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Country | US
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Telephone | 629-206-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 810 OAK MEADOW DR UNIT 680843
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City | FRANKLIN
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State | TN
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Zip | 37068-0137
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Country | US
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Telephone | 629-206-3101
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JENNIFER SWAIM
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Credential |
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Telephone | 615-779-6236
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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 |
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License Number State |
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