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Organization
CITY OF SOUTHAVEN
Active
Organization
CITY OF SOUTHAVEN
Active
Other names
Southaven Fire Department Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY BLEDSOE III (FIRE CHIEF)
(662) 280-2489
Entity
Organization
Contact information
Practice address
8710 NORTHWEST DR, SOUTHAVEN, MS 38671-2410
(662) 393-7466
(662) 393-7294
Mailing address
8710 NORTHWEST DR, SOUTHAVEN, MS 38671-2410
(662) 393-7466
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
128
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07774861
—
MS
01
—
223862186
BCBS
MS
Enumeration date
09/14/2006
Last updated
07/01/2026
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