West Coast - Southern Medical Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

002614 Issued in FL

Legal business name

WEST COAST - SOUTHERN MEDICAL SERVICE INC

Practice address

934 14TH St W
Bradenton, FL 34205-6646

Phone

(941) 748-7148

Fax

(941) 748-8520

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Carole A. McGowan, EMT-P

Title

Vice President

Phone

(941) 748-7148

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1740284785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342056646",
            "telephone_number": "941-748-7148",
            "fax_number": "941-748-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 14TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342056646",
            "telephone_number": "941-748-7148",
            "fax_number": "941-748-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST - SOUTHERN MEDICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "941-748-7148",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "FL",
            "license": "002614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG PROGRAM",
            "identifier": "080288100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400017005",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40001700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400017002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CARE",
            "identifier": "429840000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400017004",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTHCARE",
            "identifier": "00559",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590009510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR WORK COM",
            "identifier": "203246400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400017003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wepellet Bradenton LLC
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• West Bradenton Therapy Services Inc
• West Coast Dental Partners
• West Coast OB/GYN
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• West Coast Podiatry Center, Inc.
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• Land Ambulance in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Land Ambulance in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.