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General NPI Number Information
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NPI Number | 1780496554
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Entity Type | Organization
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Legal Business Name | EMS TEAM OF TENNESSEE LLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 830 FESSLERS PKWY STE 111
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City | NASHVILLE
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State | TN
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Zip | 37210-2908
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Country | US
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Telephone | 800-735-8190
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Fax | 937-877-1236
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Provider Business Mailing Address
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Address Line | 2740 W NATIONAL RD
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City | DAYTON
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State | OH
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Zip | 45414-1108
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Country | US
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Telephone | 937-877-1235
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Fax | 937-877-1236
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Authorized Official
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Title or Position | PRESIDENT
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Name | DERECK PRISTAS
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Credential |
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Telephone | 937-877-1235
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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