Provider Demographics
NPI:1629677786
Name:S.O.S MEDICAL INC
Entity Type:Organization
Organization Name:S.O.S MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BURSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD D PH
Authorized Official - Phone:580-318-0796
Mailing Address - Street 1:9561 STATE HIGHWAY 72
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63766-6109
Mailing Address - Country:US
Mailing Address - Phone:580-318-0796
Mailing Address - Fax:
Practice Address - Street 1:9561 STATE HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63766-6109
Practice Address - Country:US
Practice Address - Phone:580-318-0796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)