Organization
EMERGYSTAT OF SULLIGENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LUNAN (CEO)
(205) 695-9800
Entity
Organization
Contact information
Practice address
9420 HIGHWAY 18, VERNON, AL 35592-5211
(205) 695-9800
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
569
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51030994
BLUE CROSS PROV #
AL
01
—
51031838
BLUE CROSS PROVIDER NUMBE
AL
01
—
51037974
BLUE CROSS PROV #
AL
01
—
51076358
BLUE CROSS PROV #
AL
01
—
51094659
BLUE CROSS PROV #
AL
01
—
51096578
BLUE CROSS PROV #
AL
01
—
51098617
BLUE CROSS PROV #
AL
01
—
51510683
BLUE CROSS PROV #
AL
Enumeration date
05/02/2006
Last updated
08/22/2020
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