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NPI Code Detail

MEDICARE: COUNTY OF MONTGOMERY-OFFICE OF COUNTY JUDGE

MEDICARE: COUNTY OF MONTGOMERY-OFFICE OF COUNTY JUDGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand AmbulanceEMS0000006301TN

General Provider Information

NPI Number : 1053316265
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF MONTGOMERY-OFFICE OF COUNTY JUDGE
Provider Business Mailing Address
First Line : 601 DUNLOP LN
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5015
Country : US
Telephone Number : 931-920-1800
Fax Number : 931-645-5702
Provider Business Practice Location Address
First Line : 601 DUNLOP LN
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5015
Country : US
Telephone Number : 931-920-1800
Fax Number : 931-645-5702
Authorized Official
Title or Position : CHIEF
Name : JIMMIE EDWARDS
Credential :
Telephone Number : 931-920-1800
Provider Enumeration Date : 06/15/2005
Last Update Date : 02/19/2019

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Directions to “COUNTY OF MONTGOMERY-OFFICE OF COUNTY JUDGE ” Practice Location

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