# CITY OF HERNANDO AMBULANCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013056639
- **Authorized official:** WILLIS JOHNSON (MAYOR)
- **Authorized official phone:** (270) 744-8413

## Contact information

- **Practice address:** 475 W COMMERCE ST, HERNANDO, MS 38632-2102
- **Practice address phone:** (270) 744-8413
- **Practice address fax:** (662) 429-9099
- **Mailing address:** 475 W COMMERCE ST, HERNANDO, MS 38632-2102
- **Mailing address phone:** (662) 449-0504
- **Mailing address fax:** (662) 429-9099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 046-ADVANCED LIFE SU | MS | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 08/16/2022