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General NPI Number Information
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NPI Number | 1790231686
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Entity Type | Organization
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Legal Business Name | MEDICONE MEDICAL RESPONSE DELTA REGION INC
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 1995 HIGHWAY 51 S
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City | COVINGTON
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State | TN
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Zip | 38019-3635
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Country | US
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Telephone | 901-521-8800
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Fax | 866-215-6089
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Provider Business Mailing Address
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Address Line | 1995 HIGHWAY 51 S
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City | COVINGTON
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State | TN
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Zip | 38019-3635
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Country | US
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Telephone | 901-521-8800
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Fax | 866-215-6089
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Authorized Official
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Title or Position | OWNER
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Name | JAMES (JIM) REEVES
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Credential |
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Telephone | 217-690-5672
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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 | 10203
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License Number State | TN
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