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General NPI Number Information
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NPI Number | 1902986763
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Entity Type | Organization
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Legal Business Name | DESOTO COUNTY BOARD OF SUPERVISORS
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 365 LOSHER ST SUITE 120
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City | HERNANDO
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State | MS
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Zip | 38632-2138
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Country | US
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Telephone | 662-449-1104
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Fax | 662-429-5582
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Provider Business Mailing Address
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Address Line | 365 LOSHER ST SUITE 120
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City | HERNANDO
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State | MS
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Zip | 38632-2138
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Country | US
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Telephone | 662-449-1104
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Fax | 662-429-5582
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Authorized Official
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Title or Position | DIRECTOR OF EMERGENCY SERVICES
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Name | MR. ROBERT I STOREY JR.
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Credential |
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Telephone | 662-449-1104
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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 | 317
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License Number State | MS
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