Provider Demographics
NPI:1043216096
Name:MEDIC ONE AMBULANCE
Entity Type:Organization
Organization Name:MEDIC ONE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-984-2001
Mailing Address - Street 1:1000 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3504
Mailing Address - Country:US
Mailing Address - Phone:513-984-2001
Mailing Address - Fax:513-984-9143
Practice Address - Street 1:1000 ELM HILL PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3504
Practice Address - Country:US
Practice Address - Phone:513-984-2001
Practice Address - Fax:513-984-9143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9927341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3571572Medicaid
TN3571572Medicaid