Provider Demographics
NPI:1588640742
Name:HANCOCK COUNTY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:HANCOCK COUNTY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:V
Authorized Official - Credentials:
Authorized Official - Phone:423-733-4341
Mailing Address - Street 1:PO BOX 409
Mailing Address - Street 2:1517 MAIN ST
Mailing Address - City:SNEEDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37869
Mailing Address - Country:US
Mailing Address - Phone:423-733-4454
Mailing Address - Fax:423-733-4530
Practice Address - Street 1:1517 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869
Practice Address - Country:US
Practice Address - Phone:423-733-4454
Practice Address - Fax:423-733-4454
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF HANCOCK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-20
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS0000003401341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN65435OtherBLUECARE
TN100026344OtherTENNCARE PHP
TN3002376OtherBLUE CROSS BLUE SHIELD
TN3574330Medicaid
TN65435OtherBLUECARE