Provider Demographics
NPI:1861788713
Name:MEDICONE MEDICAL RESPONSE OF TENNESSEE INC
Entity type:Organization
Organization Name:MEDICONE MEDICAL RESPONSE OF TENNESSEE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-744-9600
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-0834
Practice Address - Street 1:2904A TAZEWELL PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1875
Practice Address - Country:US
Practice Address - Phone:270-744-9600
Practice Address - Fax:270-744-0834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICONE MEDICAL RESPONSE OF TENNESSEE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-20
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525655Medicaid
KY710018810Medicaid
NC3409858Medicaid
VA1861788713Medicaid
KY7100188790Medicaid
KY710018810Medicaid
TN103G599957Medicare PIN