Organization
COCKE COUNTY AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY A HOLT PARAMEDIC (OWNER)
(423) 608-3109
Entity
Organization
Contact information
Practice address
245 BYBEE RD, NEWPORT, TN 37821-4603
(423) 608-3109
(623) 625-4043
Mailing address
245 BYBEE RD, NEWPORT, TN 37821-4603
(423) 608-3109
(623) 625-4043
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS0000010024
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3574698
—
TN
01
—
4096970
BLUE CROSS BLUE SHEILD
TN
Enumeration date
03/29/2006
Last updated
08/22/2020
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