SOUTHEAST MS AIR AMBULANCE DISTRICT NPI 1861509895

NPI Information

NPI: 1861509895
Provider Name: SOUTHEAST MS AIR AMBULANCE DISTRICT
Classification: Ambulance - 3416A0800X
Entity Type: Organization

Specialization: Air Transport

CLIA Number: 25D0696177

Address:
207 S 28TH AVE
HATTIESBURG, MS
ZIP 39401
Phone: (601) 264-0175
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SOUTHEAST MS AIR AMBULANCE DISTRICT is an air transport ambulance in Hattiesburg, MS. SOUTHEAST MS AIR AMBULANCE DISTRICT NPI is 1861509895. The provider is registered as an organization entity type.

The provider's business location address is:

207 S 28TH AVE
HATTIESBURG, MS
ZIP 39401-155
Phone: (601) 264-0175
Fax: (601) 264-0534

The provider's authorized official is Richard Sewell .
The authorized official title is Business Office Manager and has the following contact phone number (601) 264-3581.

The CLIA number assigned to this NPI record is 25D0696177 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416A0800X	Ambulance	Air Transport	119-ALS PARAMEDIC	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00050445	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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