MEDICARE: EMS SOUTHWEST INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	04009	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316946627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMS SOUTHWEST INC

Provider Business Mailing Address
First Line	:	590 ROLLING MEADOWS ROAD
Second Line	:
City	:	WAYNESBURG
State	:	PA
Zip	:	15370
Country	:	US
Telephone Number	:	724-852-2208
Fax Number	:	724-852-3185

Provider Business Practice Location Address
First Line	:	590 ROLLING MEADOWS RD
Second Line	:
City	:	WAYNESBURG
State	:	PA
Zip	:	15370-2510
Country	:	US
Telephone Number	:	724-627-6097
Fax Number	:	724-852-3185

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID DERNAR
Credential	:
Telephone Number	:	724-325-4003

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	09/15/2017

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Directions to “EMS SOUTHWEST INC ” Practice Location

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