Provider Demographics
NPI:1770884090
Name:MID-SOUTH AMBULANCE SERVICE
Entity type:Organization
Organization Name:MID-SOUTH AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-444-7999
Mailing Address - Street 1:201 SIGNATURE PL
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3376
Mailing Address - Country:US
Mailing Address - Phone:615-444-7999
Mailing Address - Fax:615-444-7919
Practice Address - Street 1:201 SIGNATURE PL
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3376
Practice Address - Country:US
Practice Address - Phone:615-444-7999
Practice Address - Fax:615-444-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport