Provider Demographics
NPI:1194714253
Name:SCOTT COUNTY AMBULANCE SERVICE
Entity type:Organization
Organization Name:SCOTT COUNTY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-569-6000
Mailing Address - Street 1:501 PAINT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-5915
Mailing Address - Country:US
Mailing Address - Phone:423-569-6000
Mailing Address - Fax:423-569-3618
Practice Address - Street 1:501 PAINT ROCK RD
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-5915
Practice Address - Country:US
Practice Address - Phone:423-569-6000
Practice Address - Fax:423-569-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000076013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3558885Medicaid
KY55620249OtherKY MEDICAID EMERGENCY
TN892010OtherBLACK LUNG
TN1403216OtherUMWA
KY56005101OtherKY MEDICAID NON EMERGENCY
TN0104093OtherBLUE CROSS
KY56005101OtherKY MEDICAID NON EMERGENCY