MEDICARE: CITY OF CELINA

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	10040	TN
2	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1841490380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CELINA

Provider Business Mailing Address
First Line	:	PO BOX 9150
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42002-9150
Country	:	US
Telephone Number	:	270-744-9600
Fax Number	:	270-744-8642

Provider Business Practice Location Address
First Line	:	143 CORDELL HILL DRIVE
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-0000
Country	:	US
Telephone Number	:	931-243-3147
Fax Number	:	931-243-4969

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JASON EMERTON
Credential	:
Telephone Number	:	931-243-3147

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	01/07/2021

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Directions to “CITY OF CELINA ” Practice Location

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