City of Hernando Ambulance

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

046-ADVANCED LIFE SU Issued in MS

Legal business name

CITY OF HERNANDO AMBULANCE

Practice address

475 W Commerce St
Hernando, MS 38632-2102

Phone

(270) 744-8413

Fax

(662) 429-9099

NPI assigned

Feb 6, 2007

Last updated

Aug 16, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Willis Johnson

Title

Mayor

Phone

(270) 744-8413

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1013056639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W COMMERCE ST",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322102",
            "telephone_number": "662-449-0504",
            "fax_number": "662-429-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W COMMERCE ST",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322102",
            "telephone_number": "270-744-8413",
            "fax_number": "662-429-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HERNANDO AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIS",
        "authorized_official_title_or_position": "MAYOR",
        "authorized_official_telephone_number": "270-744-8413"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "046-ADVANCED LIFE SU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Childrens Dental Center Hernando LLC
• Cormelanie Shondell Chillous, PCMHT
• Eu Gene Chin, PHD INTERN
• Sushma Chowdhary, MD
• Yashwant M Chowdhary, MD
• Lecretia Williams Clark, M.ED, LPC
• William Clark0
• Paula Clay
• D'Allegra Cochran, OTD, OTR/L
• Wendy Gail Collums, RN

• Land Ambulance in Hernando, MS
• Providers in Hernando, MS by specialty
• Land Ambulance in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.