Provider Demographics
NPI:1912504119
Name:EDM ENTERPRISES, LLC
Entity Type:Organization
Organization Name:EDM ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:HUDSON
Authorized Official - Last Name:HALLUM
Authorized Official - Suffix:II
Authorized Official - Credentials:NREMTP
Authorized Official - Phone:901-301-5650
Mailing Address - Street 1:605 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2951
Mailing Address - Country:US
Mailing Address - Phone:901-301-5650
Mailing Address - Fax:
Practice Address - Street 1:524 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3233
Practice Address - Country:US
Practice Address - Phone:901-301-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport