Provider Demographics
NPI:1659348209
Name:ROANE COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:ROANE COUNTY GOVERNMENT
Other - Org Name:ROANE COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:CRESWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-882-3005
Mailing Address - Street 1:3070 ROANE STATE HWY
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-7843
Mailing Address - Country:US
Mailing Address - Phone:865-882-3005
Mailing Address - Fax:865-882-3004
Practice Address - Street 1:3070 RAONE STATE HWY
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748
Practice Address - Country:US
Practice Address - Phone:865-882-6039
Practice Address - Fax:865-882-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2002115OtherBLUE CROSS
590009123OtherMC RAILROAD
TN100020939OtherPHP
TN2002115OtherBLUE CROSS
3520303Medicare ID - Type Unspecified