Provider Demographics
NPI:1912872995
Name:ALLIANCE EMS
Entity type:Organization
Organization Name:ALLIANCE EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:MULDROW,
Authorized Official - Last Name:MULDROW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, EMT-B, CPRI
Authorized Official - Phone:980-833-4531
Mailing Address - Street 1:190 SASSAFRAS RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-0019
Mailing Address - Country:US
Mailing Address - Phone:980-833-4531
Mailing Address - Fax:
Practice Address - Street 1:190 SASSAFRAS RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-0019
Practice Address - Country:US
Practice Address - Phone:980-833-4531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NATIONAL BLACK HEALTHCARE PROFESSIONALS ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty