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General NPI Number Information
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NPI Number | 1649814401
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Entity Type | Organization
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Legal Business Name | DELTA EMS
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 1800 CHERYL ST
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City | CLARKSDALE
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State | MS
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Zip | 38614-7219
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Country | US
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Telephone | 901-430-4541
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 CHERYL ST
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City | CLARKSDALE
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State | MS
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Zip | 38614-7219
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Country | US
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Telephone | 662-374-0015
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | DEVAN EDWARD SIMPSON
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Credential |
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Telephone | 901-430-4541
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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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