Provider Demographics
NPI:1508924358
Name:UNITED EMERGENCY SERVICES OF TENNESSEE, LLC
Entity Type:Organization
Organization Name:UNITED EMERGENCY SERVICES OF TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-693-5600
Mailing Address - Street 1:861 SW 78TH AVE
Mailing Address - Street 2:# 100 B
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3273
Mailing Address - Country:US
Mailing Address - Phone:877-693-5600
Mailing Address - Fax:954-693-0005
Practice Address - Street 1:326 ASBURY AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-5577
Practice Address - Country:US
Practice Address - Phone:731-221-2484
Practice Address - Fax:731-221-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735710Medicaid
TN3735710Medicaid
TN=========OtherTAX ID NUMBER