Provider Demographics
NPI:1427173210
Name:HOUSTON COUNTY EMS
Entity type:Organization
Organization Name:HOUSTON COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-289-4711
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:3515 WEST MAIN STREET
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061
Mailing Address - Country:US
Mailing Address - Phone:931-289-4711
Mailing Address - Fax:931-289-4711
Practice Address - Street 1:3515 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061
Practice Address - Country:US
Practice Address - Phone:931-289-4711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS0000009992341600000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3574230Medicaid
TN3574230Medicare ID - Type Unspecified