Provider Demographics
NPI:1295736908
Name:MARSHALL COUNTY GOVERNMENT
Entity type:Organization
Organization Name:MARSHALL COUNTY GOVERNMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-359-0540
Mailing Address - Street 1:728 S ELLINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-3460
Mailing Address - Country:US
Mailing Address - Phone:931-359-0540
Mailing Address - Fax:931-359-0546
Practice Address - Street 1:728 SOUTH ELLINGTON PARKWAY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3460
Practice Address - Country:US
Practice Address - Phone:931-359-0540
Practice Address - Fax:931-359-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000059013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3523823Medicaid
TN4110416OtherBLUE CROSS BLUE SHIELD OF
TN2006152OtherBLUE CROSS BLUE SHIELD TN
TN4110416OtherBLUE CROSS BLUE SHIELD OF