MEDICARE: MED-CARE AMBULANCE, INC.

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
1	3416L0300X	Land Ambulance	9953	TN
2	341600000X	Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3572131	OTHER	TN	MEDICARE PTAN
3	3572131	OTHER	TN	CIGNA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376538603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-CARE AMBULANCE, INC.

Provider Business Mailing Address
First Line	:	5275 RALEIGH LAGRANGE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134
Country	:	US
Telephone Number	:	901-685-2212
Fax Number	:

Provider Business Practice Location Address
First Line	:	5275 RALEIGH LAGRANGE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134
Country	:	US
Telephone Number	:	901-685-2212
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	JAKE FARLEY
Credential	:
Telephone Number	:	901-282-9079

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	06/25/2024

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