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General NPI Number Information
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NPI Number | 1073571709
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Entity Type | Organization
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Legal Business Name | HARTSELLE EMERGENCY SERVICES, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 201 PINE ST NW
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City | HARTSELLE
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State | AL
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Zip | 35640-2309
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Country | US
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Telephone | 256-751-3000
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Fax | 904-805-1302
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Provider Business Mailing Address
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Address Line | PO BOX 863535
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City | ORLANDO
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State | FL
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Zip | 32886-3535
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Country | US
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Telephone | 904-805-1300
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Fax | 904-805-1302
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Authorized Official
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Title or Position | CHAIRMAN/PRESIDENT/CEO
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Name | ROBERT J BUNKER
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Credential |
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Telephone | 904-805-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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