Healthcare Provider Details

I. General information

NPI: 1649200890
Provider Name (Legal Business Name): SOUTHERN PARAMEDIC SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N NEW ORLEANS STREET
BRINKLEY AR
72021
US

IV. Provider business mailing address

PO BOX 88
BRINKLEY AR
72021
US

V. Phone/Fax

Practice location:
  • Phone: 870-589-2206
  • Fax: 870-589-2206
Mailing address:
  • Phone: 870-589-2206
  • Fax: 870-589-2206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY W PADGET
Title or Position: CEO
Credential:
Phone: 870-589-2206