Provider Demographics
NPI:1649510918
Name:MED STAT AMBULANCE LLC
Entity type:Organization
Organization Name:MED STAT AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-927-0770
Mailing Address - Street 1:PO BOX 331045
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-1045
Mailing Address - Country:US
Mailing Address - Phone:615-927-0770
Mailing Address - Fax:615-904-0303
Practice Address - Street 1:1022 SAMSONITE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4233
Practice Address - Country:US
Practice Address - Phone:615-927-0770
Practice Address - Fax:615-904-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN102123416L0300X
TN102113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport