Provider Demographics
NPI:1245381532
Name:RHEA AMBULANCE SERVICES LLC
Entity Type:Organization
Organization Name:RHEA AMBULANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DARYLE
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-775-2143
Mailing Address - Street 1:9460 RHEA COUNTY HWY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-7922
Mailing Address - Country:US
Mailing Address - Phone:423-775-2143
Mailing Address - Fax:423-775-4725
Practice Address - Street 1:9460 RHEA COUNTY HWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-7922
Practice Address - Country:US
Practice Address - Phone:423-775-2143
Practice Address - Fax:423-775-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000072013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4116821OtherBLUE CROSS BLUE SHIELD
TN4116821OtherTENNCARE SELECT
TN3574836Medicaid
TN4116821OtherTENNCARE BLUECARE
TN4116821OtherTENNCARE SELECT