Southern EMS LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

2295-6669 Issued in WV

Legal business name

SOUTHERN EMS LLC

Practice address

HC 68 Box 456
Hanover, WV 24839-9731

Phone

(304) 664-3848

Fax

(304) 664-3669

NPI assigned

Oct 28, 2014

Last updated

Oct 28, 2014By 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

Mr. Tyler Michael Blankenship

Title

Manager

Phone

(304) 664-3848

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1417352840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 456",
            "city": "JUSTICE",
            "state": "WV",
            "postal_code": "248510456",
            "telephone_number": "304-664-3848",
            "fax_number": "304-664-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 68 BOX 456",
            "city": "HANOVER",
            "state": "WV",
            "postal_code": "248399731",
            "telephone_number": "304-664-3848",
            "fax_number": "304-664-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "304-664-3848",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WV",
            "license": "2295-6669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Lawrence
• Misty Lester
• Janice Ann May
• Erica Dawn Mitchell
• Crystal Short
• Kimberly Taylor
• Abigail Toler
• Brandi Nichole Vanover

• Ambulance in Hanover, WV
• Providers in Hanover, WV by specialty
• Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.