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General NPI Number Information
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NPI Number | 1780676536
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Entity Type | Organization
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Legal Business Name | SOUTHERN COVE EMERGENCY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 3259 BRUMBAUGH RD
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City | NEW ENTERPRISE
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State | PA
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Zip | 16664-8817
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Country | US
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Telephone | 814-766-2676
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Fax | 814-766-2011
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Provider Business Mailing Address
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Address Line | PO BOX 102
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City | NEW ENTERPRISE
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State | PA
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Zip | 16664-0102
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Country | US
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Telephone | 814-766-2676
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Fax | 814-766-2011
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Authorized Official
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Title or Position | SECRETARY
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Name | TINA WALTER
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Credential |
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Telephone | 814-766-2676
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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 | 04257
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License Number State | PA
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