Healthcare Provider Details

I. General information

NPI: 1013269802
Provider Name (Legal Business Name): EMERGENCY SERVICES OF MOBILE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

PO BOX 637943
CINCINNATI OH
45263-7943
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2400
  • Fax: 251-431-2543
Mailing address:
  • Phone: 800-424-3672
  • Fax: 954-377-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TONYA LYNN SCANLAN
Title or Position: PROVIDER ENROLLMENT DIRECTOR
Credential:
Phone: 954-377-2954