Healthcare Provider Details

I. General information

NPI: 1689679193
Provider Name (Legal Business Name): EMERGENCY MOBILE HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6972 APPLING FARMS PKWY SUITE 110
MEMPHIS TN
38133-4725
US

IV. Provider business mailing address

PO BOX 382550
GERMANTOWN TN
38183-2550
US

V. Phone/Fax

Practice location:
  • Phone: 901-818-0911
  • Fax: 901-377-1599
Mailing address:
  • Phone: 901-818-0911
  • Fax: 901-377-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number10175
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number315
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberEMS0000009975
License Number StateTN

VIII. Authorized Official

Name: ELBERT O'NEAL ELLIS
Title or Position: EMS DIRECTOR
Credential: PARAMEDIC
Phone: 901-271-5024