# SOUTHEAST SHELBY COUNTY EMERGENCY MEDICAL RESCUE INC

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

## Provider details

- **NPI number:** 1033205612
- **Authorized official:** COBY CARDEN (CHIEF)
- **Authorized official phone:** (205) 669-4866

## Contact information

- **Practice address:** 103 HIGHWAY 47 S, COLUMBIANA, AL 35051-9464
- **Practice address phone:** (205) 669-4866
- **Mailing address:** PO BOX 857, COLUMBIANA, AL 35051-0857
- **Mailing address phone:** (205) 729-3089
- **Mailing address fax:** (205) 669-4886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 374 | AL | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 02/06/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 051530848 | BLUE CROSS | — |
| 05 | — | 051556446 | — | AL |