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Organization

SEMO EMS INC

Active
Other names
Bollinger County EMS
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDALL LEE TUCKER EMT-P (PRESIDENT)
(573) 238-3059
Entity
Organization

Contact information

Practice address
RR 2 BOX 2162, HWY 34 EAST, MARBLE HILL, MO 63764-9502
(573) 238-4837
Mailing address
PO BOX 91, MARBLE HILL, MO 63764-0091
(573) 238-4837
(573) 238-3228

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
017019
MO
3416L0300X
Land Ambulance
Primary
017051
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130913
BLUE CROSS BLUE SHIELD
05
800461808
MO
05
806927901
MO
Enumeration date
01/12/2007
Last updated
11/23/2016
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