PUCKETT EMERGENCY MEDICAL SERVICES, LLC (NPI# 1720300379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720300379 |
| Entity Type | Organization |
| Organization Name | PUCKETT EMERGENCY MEDICAL SERVICES, LLC |
| Other Organization Name | PUCKETT EMERGENCY MEDICAL SERVICES, INC |
| Practice Address |
5603 Ringgold Rd East Ridge TN 37412-3131 |
| Mailing Address |
3760 Tramore Pointe Pkwy Austell GA 30106-6823 |
| Practice Telephone | 4238941800 |
| Practice Fax Number | 7709435150 |
| Mailing Telephone | 7702225045 |
| Mailing Fax Number | 7709435150 |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. ROBERT A JEWELL (VP-REVENUE CYCLE) |
| Authorized Official Telephone | 8445974911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 341600000X | Ambulance | 10123 | TN | Transportation Services |
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
10123 | TN | Transportation Services |
| Other Name | Type Code |
|---|---|
| PUCKETT EMERGENCY MEDICAL SERVICES | Doing Business As Name - Organization |
| PUCKETT EMERGENCY MEDICAL SERVICES, INC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699769158 | Puckett Emergency Medical Services, LLC | Ambulance | 3760 Tramore Point Pkwy, Austell, GA 30106 | 2005-09-09 |
| Street Address |
5603 RINGGOLD RD |
| City | EAST RIDGE |
| State | TN |
| Zip Code | 37412-3131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316482458 | East Ridge Snf Operations, LLC | Skilled Nursing Facility | 1502 Mcdonald Rd., East Ridge, TN 37412 | 2016-12-28 |
| 1487080149 | Puckett Med Van LLC | Non-emergency Medical Transport (VAN) | 5603 Ringgold Road, East Ridge, TN 37412 | 2013-09-25 |
| 1538420229 | Nathan Hartgrove | Internal Medicine | 961 Spring Creek Rd Ste 300, Chattanooga, TN 37412 | 2012-05-30 |
| 1770869042 | Jonathan Bailey Barnett I | Pharmacist | 5301 Ringold Rd, East Ridge, TN 37412 | 2011-10-31 |
| 1932482791 | Ronald P Leonard | Pharmacist | 7354 East Brainerd Rd, Chattanooga, TN 37412 | 2011-09-27 |
| 1164758561 | Zoilus, Inc | Home Health | 912 Belvoir Hills Circle, Chattanooga, TN 37412 | 2009-10-20 |
| 1093935157 | Alan L Crisman | Dentist | 1421 Armour Street, Chattanooga, TN 37412 | 2007-04-30 |
| 1700949989 | Keith Brian Sparkman | Optometrist | 1013 Spring Creek Rd, Chattanooga, TN 37412 | 2006-12-18 |
| 1174617161 | Shahul H Majeed | Obstetrics & Gynecology | 1012 Spring Creek Road, Chattanooga, TN 37412 | 2006-10-03 |
| 1356434070 | Mckinley Snipes Lundy Sr. | Preventive Medicine | 931 Spring Creek Road, Suite 200, Chattanooga, TN 37412 | 2006-10-02 |
| Find all providers in zip 37412 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1528693439 | Advantage Care Ems | Ambulance | 1309 Briarville Rd Ste 202, Madison, TN 37115-5132 | 2020-03-11 |
| 1669028551 | City of Martin Tennessee | Ambulance | 106 Neal St, Martin, TN 38237-2418 | 2019-08-15 |
| 1861900961 | First Call Ambulance LLC | Ambulance | 627 Old Hickory Blvd, Old Hickory, TN 37138-3162 | 2018-01-11 |
| 1710495858 | Lifetech Ambulance, LLC | Ambulance | 2874 Shelby St Ste 150, Bartlett, TN 38134 | 2018-01-10 |
| 1154849115 | Lifeline Ambulance Service, Inc. | Ambulance | 1110 Highway 33 S, New Tazewell, TN 37825-7027 | 2017-08-30 |
| 1417487786 | Firstcare Ambulance Service, LLC | Ambulance | 5155 Wilfong Rd, Memphis, TN 38134-5611 | 2017-06-19 |
| 1083158570 | Shelby County Government | Ambulance | 1075 Mullins Station Rd, Bldg. C, 2nd Floor, Memphis, TN 38134-7730 | 2016-12-19 |
| 1245789452 | Americare Emergency Medical Service, LLC | Ambulance | 1321 Murfreesboro Pike Ste 601, Nashville, TN 37217-2677 | 2016-09-28 |
| 1851844633 | Med Transport Memphis, LLC | Ambulance | 1005 Tillman St Ste 213, Memphis, TN 38112-2038 | 2016-07-28 |
| Find all providers with the same taxonomy | ||||
| City | EAST RIDGE |
| Zip Code | 37412 |
Please comment or provide details below to improve the information on PUCKETT EMERGENCY MEDICAL SERVICES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.