MEDICARE: MED EXPRESS OF MISSISSPPI

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	177	MS

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	:	1912965617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED EXPRESS OF MISSISSPPI

Provider Business Mailing Address
First Line	:	PO BOX 1497
Second Line	:
City	:	VERNON
State	:	AL
Zip	:	35592-1497
Country	:	US
Telephone Number	:	205-695-9800
Fax Number	:	205-695-7677

Provider Business Practice Location Address
First Line	:	121A LANCASTER CIR
Second Line	:
City	:	HOUSTON
State	:	MS
Zip	:	38851-8767
Country	:	US
Telephone Number	:	205-695-9800
Fax Number	:	205-695-7677

Authorized Official
Title or Position	:	CEO
Name	:	LARRY LUNAN
Credential	:
Telephone Number	:	205-695-9800

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/22/2020

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Directions to “MED EXPRESS OF MISSISSPPI ” Practice Location

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