Provider Demographics
NPI:1316946627
Name:EMS SOUTHWEST INC
Entity type:Organization
Organization Name:EMS SOUTHWEST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DERNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-325-4003
Mailing Address - Street 1:590 ROLLING MEADOWS ROAD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370
Mailing Address - Country:US
Mailing Address - Phone:724-852-2208
Mailing Address - Fax:724-852-3185
Practice Address - Street 1:590 ROLLING MEADOWS RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-2510
Practice Address - Country:US
Practice Address - Phone:724-627-6097
Practice Address - Fax:724-852-3185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015087900004Medicaid
PA234016Medicare PIN