MEDICARE: SAMARITAN EMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	929	AL

General Provider Information

NPI Number	:	1558482943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN EMS, INC.

Provider Business Mailing Address
First Line	:	15410 HIGHWAY 231
Second Line	:
City	:	UNION GROVE
State	:	AL
Zip	:	35175
Country	:	US
Telephone Number	:	256-261-9335
Fax Number	:

Provider Business Practice Location Address
First Line	:	15410 HIGHWAY 231
Second Line	:
City	:	UNION GROVE
State	:	AL
Zip	:	35175
Country	:	US
Telephone Number	:	256-261-9335
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MR. BENJAMEN YANHKO
Credential	:	EMT-P
Telephone Number	:	256-261-9335

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/22/2020

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