=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932199460
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF LAWRENCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2005
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 416 W GAINES ST
-----------------------------------------------------
City | LAWRENCEBURG
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38464-3111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-762-3566
-----------------------------------------------------
Fax | 931-766-1582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 547
-----------------------------------------------------
City | WHEELING
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60090-0547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-224-4474
-----------------------------------------------------
Fax | 336-791-0196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | VIOLA MICHELLE AYERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 931-762-3566
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | EMS0000005001
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------