SOUTHEAST AMBULANCE LLC NPI 1861551731

NPI Information

NPI: 1861551731
Provider Name: SOUTHEAST AMBULANCE, LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
2511 RIVERSIDE DR
SUITE C-3
CHATTANOOGA, TN
ZIP 37406
Phone: (423) 624-9990
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SOUTHEAST AMBULANCE, LLC is a land transport ambulance in Chattanooga, TN. SOUTHEAST AMBULANCE, LLC NPI is 1861551731. The provider is registered as an organization entity type.

The provider's business location address is:

2511 RIVERSIDE DR
SUITE C-3
CHATTANOOGA, TN
ZIP 37406-700
Phone: (423) 624-9990

The provider's authorized official is Jimmy E Henderlight .
The authorized official title is Managing Member and has the following contact phone number (423) 624-9990.

The enumeration date for this NPI number is 12/7/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	EMS0000010029	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3474827	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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