Healthcare Provider Details

I. General information

NPI: 1386634442
Provider Name (Legal Business Name): SOUTHWEST EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311C HIGHWAY 71 N
MENA AR
71953-8447
US

IV. Provider business mailing address

1311C HIGHWAY 71 N
MENA AR
71953-8447
US

V. Phone/Fax

Practice location:
  • Phone: 479-394-7300
  • Fax: 479-394-3555
Mailing address:
  • Phone: 479-394-7300
  • Fax: 479-394-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number731
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number529
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number705
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number864
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number874
License Number StateAR
# 6
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number875
License Number StateAR

VIII. Authorized Official

Name: MR. ROBERT F HINES
Title or Position: OWNER
Credential:
Phone: 479-394-5400