Healthcare Provider Details

I. General information

NPI: 1396030995
Provider Name (Legal Business Name): AMORY EMERGENCY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 EARL FRYE BLVD
AMORY MS
38821-5500
US

IV. Provider business mailing address

200 CORPORATE BLVD SUITE 201
LAFAYETTE LA
70508-3870
US

V. Phone/Fax

Practice location:
  • Phone: 662-256-7111
  • Fax: 662-256-3133
Mailing address:
  • Phone: 800-893-9698
  • Fax: 337-371-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WILLIAM C SCHUMACHER
Title or Position: CEO
Credential: MD
Phone: 800-893-9698