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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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