Organization
COUNTY OF GRAINGER
Active
Other names
Grainger County Ambulance Authority
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON MCDANIEL (OFFICE MANAGER)
(865) 828-3682
Entity
Organization
Contact information
Practice address
270 JUSTICE CENTER DRIVE,, SUITE 101, RUTLEDGE, TN 37861
(865) 828-3682
(865) 828-3713
Mailing address
PO BOX 863, LEWISVILLE, NC 27023-0863
(336) 766-4448
(336) 766-1279
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2901
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000043400
BLUE CROSS BLUE SHIELD
TN
01
—
100022008
PHP
TN
01
—
3547821
TENNCARE BUREAU
TN
05
—
3547821
—
TN
01
—
590002706
RAILROAD MEDICARE
TN
01
—
702004413
CARITEN & CARITEN SENIOR
TN
01
—
7102000TN3786
BLUE CROSS BLUE SHIELD OF
MI
01
—
912926000
FLORIDA MEDICAID
FL
Enumeration date
10/31/2005
Last updated
03/26/2009
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