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General NPI Number Information
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NPI Number | 1740284785
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Entity Type | Organization
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Legal Business Name | WEST COAST - SOUTHERN MEDICAL SERVICE INC
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 934 14TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-6646
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Country | US
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Telephone | 941-748-7148
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Fax | 941-748-8520
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Provider Business Mailing Address
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Address Line | 934 14TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-6646
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Country | US
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Telephone | 941-748-7148
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Fax | 941-748-7265
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. CAROLE A. MCGOWAN
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Credential | EMT-P
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Telephone | 941-748-7148
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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 | 002614
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License Number State | FL
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