# LAWRENCE COUNTY EMERGENCY MEDICAL SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greg's Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548246010
- **Authorized official:** MR. GREGORY DAREL RANDOLPH PARAMEDIC (PRESIDENT)
- **Authorized official phone:** (256) 974-3711

## Contact information

- **Practice address:** 11227 AL HIGHWAY 157, SUITE A, MOULTON, AL 35650-1983
- **Practice address phone:** (256) 974-3711
- **Practice address fax:** (256) 974-7956
- **Mailing address:** PO BOX 520, MOULTON, AL 35650-0520
- **Mailing address phone:** (256) 974-3711
- **Mailing address fax:** (256) 974-7956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 725 | AL | Yes |

## Other

- **Enumeration date:** 12/16/2005
- **Last updated:** 10/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200040104 | — | AL |
| 01 | — | 510 39489 | BLUE CROSS BLUE SHIELD | AL |