Organization
SOUTHEAST MS AIR AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD SEWELL (BUSINESS OFFICE MANAGER)
(601) 264-3581
Entity
Organization
Contact information
Practice address
207 S 28TH AVE, HATTIESBURG, MS 39401-7155
(601) 264-0175
(601) 264-0534
Mailing address
207 S 28TH AVE, HATTIESBURG, MS 39401-7155
(601) 264-0175
(601) 264-0534
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
119-ALS PARAMEDIC
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00050445
—
MS
Enumeration date
08/24/2006
Last updated
08/22/2020
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