Provider Demographics
NPI:1992799233
Name:CARTER COUNTY EMERGENCY & RESCUE SQUAD, INC
Entity type:Organization
Organization Name:CARTER COUNTY EMERGENCY & RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-543-5445
Mailing Address - Street 1:PO BOX 776
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37644-0776
Mailing Address - Country:US
Mailing Address - Phone:423-542-8421
Mailing Address - Fax:423-543-4323
Practice Address - Street 1:105 IODENT WAY
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-6003
Practice Address - Country:US
Practice Address - Phone:423-542-8421
Practice Address - Fax:423-543-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000010013416L0300X
TN1001013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3561580Medicaid
GA477503002AOtherPEACHCARE
TN590007149OtherPGBA
TN4110142OtherBCBS
TN590007149OtherPGBA