Organization
HARTSELLE EMERGENCY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J BUNKER (CHAIRMAN/PRESIDENT/CEO)
(904) 805-1300
Entity
Organization
Contact information
Practice address
201 PINE ST NW, HARTSELLE, AL 35640-2309
(256) 751-3000
(904) 805-1302
Mailing address
PO BOX 863535, ORLANDO, FL 32886-3535
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529923980
—
AL
01
—
DB7627
RAIL ROAD MEDICARE
AL
Enumeration date
05/03/2006
Last updated
07/23/2008
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