Provider Demographics
NPI:1184633679
Name:WASHINGTON COUNTY-JOHNSON CITY EMERGENCY MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:WASHINGTON COUNTY-JOHNSON CITY EMERGENCY MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:423-975-5500
Mailing Address - Street 1:PO BOX 5928
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-5928
Mailing Address - Country:US
Mailing Address - Phone:844-347-1063
Mailing Address - Fax:888-974-1293
Practice Address - Street 1:296 WESLEY ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1720
Practice Address - Country:US
Practice Address - Phone:423-975-5500
Practice Address - Fax:423-975-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000090013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4110024OtherBLUE CROSS BLUE SHIELD
TN3521311Medicare ID - Type Unspecified