Organization
SEVIER COUNTY AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LARRY WATERS (COUNTY MAYOR)
(865) 453-3248
Entity
Organization
Contact information
Practice address
718 MIDDLE CREEK RD, SEVIERVILLE, TN 37862-5019
(865) 453-3248
(865) 453-4232
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-8413
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100020918
PHP TENNCARE ID #
TN
01
—
246638
ANTHEM BC ID #
KY
05
—
3524914
—
TN
01
—
4110001
BLUE CROSS OF TN ID #
TN
01
—
702002153
CARITEN ID #
TN
01
—
9637
BLUE CROSS ID #
TN
Enumeration date
10/27/2005
Last updated
03/12/2021
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