Provider Demographics
NPI:1396829081
Name:WEAKLEY COUNTY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:WEAKLEY COUNTY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-364-5002
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:270-744-8642
Practice Address - Street 1:8220 HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:TN
Practice Address - Zip Code:38225-2354
Practice Address - Country:US
Practice Address - Phone:731-364-5002
Practice Address - Fax:731-364-6728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000092013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374OtherTLC
TN053623OtherOMNI
TN118361OtherBETTER HEALTH (UNISON)
TN4110073OtherBLUE CROSS/BLUE SHIELD
TN28186OtherTNCARE SELECT
TN3545391Medicaid
TN4110073OtherBLUE CROSS/BLUE SHIELD