Provider Demographics
NPI:1932385135
Name:TROUSDALE COUNTY
Entity Type:Organization
Organization Name:TROUSDALE COUNTY
Other - Org Name:HARTSVILLE / TROUSDALE AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLIFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-374-2461
Mailing Address - Street 1:210 BROADWAY RM 5
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1304
Mailing Address - Country:US
Mailing Address - Phone:615-374-9503
Mailing Address - Fax:615-374-4383
Practice Address - Street 1:95 RIVER VALLEY CT
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1747
Practice Address - Country:US
Practice Address - Phone:615-374-9503
Practice Address - Fax:615-374-4383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TROUSDALE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-17
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10036341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance