Basic Information
| Provider Information | |||||||||
| NPI: | 1396829081 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEAKLEY COUNTY AMBULANCE SERVICE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9150 | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420029150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707449600 | ||||||||
| FaxNumber: | 2707448642 | ||||||||
| Practice Location | |||||||||
| Address1: | 8220 HIGHWAY 22 | ||||||||
| Address2: | |||||||||
| City: | DRESDEN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 382252354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7313645002 | ||||||||
| FaxNumber: | 7313646728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 12/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | ANDREWS | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7313645002 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | EMS0000009201 | TN | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 3374 | 01 | TN | TLC | OTHER | 053623 | 01 | TN | OMNI | OTHER | 118361 | 01 | TN | BETTER HEALTH (UNISON) | OTHER | 4110073 | 01 | TN | BLUE CROSS/BLUE SHIELD | OTHER | 28186 | 01 | TN | TNCARE SELECT | OTHER | 3545391 | 05 | TN | MEDICAID |