Provider Demographics
NPI:1144046954
Name:GALLATIN COUNTY EMS LLC
Entity type:Organization
Organization Name:GALLATIN COUNTY EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-841-3058
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:SHAWNEETOWN
Mailing Address - State:IL
Mailing Address - Zip Code:62984-0122
Mailing Address - Country:US
Mailing Address - Phone:618-841-3058
Mailing Address - Fax:580-628-2267
Practice Address - Street 1:391 E. POSEY AVE.
Practice Address - Street 2:
Practice Address - City:SHAWNEETOWN
Practice Address - State:IL
Practice Address - Zip Code:62984
Practice Address - Country:US
Practice Address - Phone:618-844-3058
Practice Address - Fax:580-628-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport