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General NPI Number Information
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NPI Number | 1235529363
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Entity Type | Organization
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Legal Business Name | PRIDEMARK EMS, LLC
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 104 N WHALEY ST
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City | OPP
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State | AL
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Zip | 36467-2142
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Country | US
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Telephone | 334-493-0299
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Fax | 334-493-0299
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Provider Business Mailing Address
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Address Line | 104 N WHALEY ST
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City | OPP
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State | AL
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Zip | 36467-2142
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Country | US
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Telephone | 334-493-0299
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Fax | 334-493-0299
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Authorized Official
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Title or Position | MEDICAL BILLING MANAGER
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Name | BOBBIE L JOWERS
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Credential |
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Telephone | 334-764-4476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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