Provider Demographics
NPI:1073591996
Name:SOUTH TAYLOR EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:SOUTH TAYLOR EMERGENCY MEDICAL SERVICE
Other - Org Name:SOUTH TAYLOR EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-500-4950
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:1458 COUNTY ROAD 314
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-6126
Practice Address - Country:US
Practice Address - Phone:325-500-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2210023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000419401Medicaid
TX514835Medicare ID - Type Unspecified