Provider Demographics
NPI:1588949267
Name:SOUTHWEST AMBULANCE SERVICE LLC
Entity type:Organization
Organization Name:SOUTHWEST AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-807-7359
Mailing Address - Street 1:PO BOX 3668
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-3668
Mailing Address - Country:US
Mailing Address - Phone:276-807-7359
Mailing Address - Fax:276-807-7451
Practice Address - Street 1:10746 NORTON-COEBURN RD
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-6410
Practice Address - Country:US
Practice Address - Phone:276-807-7359
Practice Address - Fax:276-807-7451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance