Organization
MIDWEST EMERGENCY MANAGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARMON L. GLOVER III DO (PRESIDENT/CMO)
(888) 577-6337
Entity
Organization
Contact information
Practice address
1512 N GREEN MOUNT RD, O FALLON, IL 62269-1953
(618) 624-3750
Mailing address
PO BOX 797069, ST. LOUIS, MO 63179-7000
(888) 577-6337
(618) 624-3387
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08232205
BLUE CROSS BLUE SHIELD
IL
01
—
DF2610
RAILROAD MEDICARE
IL
Enumeration date
05/27/2006
Last updated
03/15/2018
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