Provider Demographics
NPI:1780496554
Name:EMS TEAM OF TENNESSEE LLC
Entity type:Organization
Organization Name:EMS TEAM OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DERECK
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-877-1235
Mailing Address - Street 1:2740 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-1108
Mailing Address - Country:US
Mailing Address - Phone:937-877-1235
Mailing Address - Fax:937-877-1236
Practice Address - Street 1:830 FESSLERS PKWY STE 111
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-2908
Practice Address - Country:US
Practice Address - Phone:800-735-8190
Practice Address - Fax:937-877-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)