Organization
LIFEGUARD AMBULANCE SERVICE OF TENNESSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W ROCHE (CEO PRESIDENT)
(205) 380-2065
Entity
Organization
Contact information
Practice address
1933 ELM TREE DR, NASHVILLE, TN 37210-3717
(615) 724-1911
(615) 724-1048
Mailing address
P.O. BOX 11361, BIRMINGHAM, AL 35202-1361
(205) 380-2065
(205) 380-2074
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
EMS0000010028
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3574708
—
TN
Enumeration date
07/19/2005
Last updated
11/10/2010
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