Healthcare Provider Details

I. General information

NPI: 1225875719
Provider Name (Legal Business Name): SRMC EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 POLE CREEK XING
SIDNEY NE
69162-2901
US

IV. Provider business mailing address

1000 POLE CREEK XING
SIDNEY NE
69162-2901
US

V. Phone/Fax

Practice location:
  • Phone: 308-254-5064
  • Fax:
Mailing address:
  • Phone: 308-254-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: KELLY K UTLEY
Title or Position: CFO
Credential:
Phone: 308-249-0052