Organization
WEST COAST - SOUTHERN MEDICAL SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLE A. MCGOWAN EMT-P (VICE PRESIDENT)
(941) 748-7148
Entity
Organization
Contact information
Practice address
934 14TH ST W, BRADENTON, FL 34205-6646
(941) 748-7148
(941) 748-8520
Mailing address
934 14TH ST W, BRADENTON, FL 34205-6646
(941) 748-7148
(941) 748-7265
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
002614
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00559
UNIVERSAL HEALTHCARE
—
01
—
080288100
BLACK LUNG PROGRAM
—
01
—
203246400
US DEPT OF LABOR WORK COM
—
05
—
40001700
—
FL
05
—
400017002
—
FL
05
—
400017003
—
FL
05
—
400017004
—
FL
05
—
400017005
—
FL
01
—
429840000
MAINE CARE
—
01
—
590009510
RAILROAD MEDICARE
—
Enumeration date
06/08/2005
Last updated
11/28/2012
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