Organization
COUNTY OF RUTHERFORD OFFICE OF BUDGET DIRECTOR
Active
Other names
Rutherford County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
KACY MARIE DAVENPORT (MEDICAL COMPLIANCE OFFICER)
(615) 898-7790
Entity
Organization
Contact information
Practice address
611 E LYTLE ST, MURFREESBORO, TN 37130-3919
(615) 898-7790
(615) 898-7952
Mailing address
611 E. LYTLE ST., MURFREESBORO, TN 37130
(615) 217-0064
(615) 898-7952
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS0000007501
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01040561
AMERIGROUP COMMUNITY CARE
TN
01
—
1401514
HEALTHSPRING
TN
05
—
3524565
—
TN
01
—
590101329
RAILROAD MEDICARE
TN
01
—
9852
BLUE CROSS OF TN
TN
Enumeration date
06/21/2005
Last updated
03/16/2021
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