Organization
EXTENDED EMERGENCY MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LUNAN (CEO)
(205) 695-9800
Entity
Organization
Contact information
Practice address
779 LAKESIDE DR, MOBILE, AL 36693-5113
(251) 660-0061
(251) 662-8205
Mailing address
PO BOX 1497, VERNON, AL 35592-1497
(205) 695-9800
(205) 695-7677
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
764
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51050095
BLUE CROSS PROV #
AL
Enumeration date
05/02/2006
Last updated
08/22/2020
Update your record
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