Provider Demographics
NPI:1013060755
Name:SOUTHWEST MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:SOUTHWEST MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHUETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-486-6809
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-5011
Mailing Address - Country:US
Mailing Address - Phone:270-824-8123
Mailing Address - Fax:
Practice Address - Street 1:210 S MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501
Practice Address - Country:US
Practice Address - Phone:812-254-7474
Practice Address - Fax:812-254-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN03623416L0300X, 146M00000X, 146N00000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000186416OtherANTHEM
IN100289200AMedicaid
IN=========OtherTAX ID NUMBER
IN100289200AMedicaid
IN=========OtherTAX ID NUMBER
986690Medicare PIN