Provider Demographics
NPI:1225278625
Name:BENCHMARK MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:BENCHMARK MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STAFFORD
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, NREMT-P
Authorized Official - Phone:865-774-1166
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-0564
Mailing Address - Country:US
Mailing Address - Phone:865-774-1166
Mailing Address - Fax:865-429-3570
Practice Address - Street 1:1416 RIVER RUN CIR
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37876-0199
Practice Address - Country:US
Practice Address - Phone:865-774-1166
Practice Address - Fax:865-429-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0538563251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)