MEDICARE: SOUTHERN PARAMEDIC SERVICE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649200890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN PARAMEDIC SERVICE INC

Provider Business Mailing Address
First Line	:	PO BOX 88
Second Line	:
City	:	BRINKLEY
State	:	AR
Zip	:	72021
Country	:	US
Telephone Number	:	870-589-2206
Fax Number	:	870-589-2206

Provider Business Practice Location Address
First Line	:	210 N NEW ORLEANS STREET
Second Line	:
City	:	BRINKLEY
State	:	AR
Zip	:	72021
Country	:	US
Telephone Number	:	870-589-2206
Fax Number	:	870-589-2206

Authorized Official
Title or Position	:	CEO
Name	:	MR. GARY W PADGET
Credential	:
Telephone Number	:	870-589-2206

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	01/08/2025

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Directions to “SOUTHERN PARAMEDIC SERVICE INC ” Practice Location

Language	Start Address	Practice Location

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