Organization
SOUTHARK EMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANNON SHAVER (PRES.)
(870) 853-4800
Entity
Organization
Contact information
Practice address
908 N MAIN ST, HAMBURG, AR 71646-2722
(870) 853-4800
(870) 881-8989
Mailing address
PO BOX 127, HAMBURG, AR 71646-0127
(870) 853-4800
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
491
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00150820
RAILROAD MEDICARE
AR
Enumeration date
09/22/2006
Last updated
08/22/2020
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