Provider Demographics
NPI:1538238936
Name:PIEDMONT EMERGENCY RESCUE
Entity type:Organization
Organization Name:PIEDMONT EMERGENCY RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:NR CCEMTP
Authorized Official - Phone:256-447-3089
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:AL
Mailing Address - Zip Code:36272-0333
Mailing Address - Country:US
Mailing Address - Phone:256-447-3089
Mailing Address - Fax:256-447-3085
Practice Address - Street 1:121 W LADIGA ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:AL
Practice Address - Zip Code:36272
Practice Address - Country:US
Practice Address - Phone:256-447-3089
Practice Address - Fax:256-447-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL200008104Medicaid
AL200008104Medicaid