Healthcare Provider Details

I. General information

NPI: 1992037840
Provider Name (Legal Business Name): ALABAMA EM-I MEDICAL SERVICES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 18TH ST
ANNISTON AL
36207-3952
US

IV. Provider business mailing address

PO BOX 98672
LAS VEGAS NV
89193-8672
US

V. Phone/Fax

Practice location:
  • Phone: 256-235-8955
  • Fax: 256-235-8776
Mailing address:
  • Phone: 800-507-8874
  • Fax: 727-536-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. GREGORY J. BYRNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 800-507-8874