Organization
CITY OF SOUTHAVEN
Active
Other names
Southaven Fire Department Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY SCALLIONS (FIRE CHIEF)
(662) 393-7466
Entity
Organization
Contact information
Practice address
8710 NORTHWEST DR, SOUTHAVEN, MS 38671-2410
(662) 393-7466
(662) 393-7294
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
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
02/03/2022
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