Provider Demographics
NPI:1629107263
Name:METROPOLITAN LYNCHBURG-MOORE COUNTY
Entity type:Organization
Organization Name:METROPOLITAN LYNCHBURG-MOORE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC SAFETY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-464-1009
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-0429
Mailing Address - Country:US
Mailing Address - Phone:800-814-5339
Mailing Address - Fax:336-518-6342
Practice Address - Street 1:1333 MAIN ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:TN
Practice Address - Zip Code:37352-8321
Practice Address - Country:US
Practice Address - Phone:931-759-7272
Practice Address - Fax:931-759-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS0000006401341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN628252200OtherDOL
TN3528231Medicaid