Organization
SEMO EMS INC
Active
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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