SOUTHERN EMS LLC — NPI 1417352840 (Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance in HANOVER, WV)

CMS-1500 Box 24J / 33a • NPI

1417352840

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

341600000X (CMS 59)

Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance

Box 32 Service Location & ZIP+4

HC 68 BOX 456, HANOVER, WV, 24839-9731

✓ 9-Digit EDI 837 ZIP+4 (24839-9731)

Practice Phone & Referral Fax

(304) 664-3848

Fax: (304) 664-3669

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1417352840 (SOUTHERN EMS LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1417352840` (NPI-2 Organization / Facility)
Provider / Legal Name	SOUTHERN EMS LLC
Plain-English Specialty	Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: `341600000X` (Ambulance)
Certifying / Licensing Body	State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Practice Location Address	HC 68 BOX 456, HANOVER, WV, 24839-9731
Practice Telephone / Fax	Tel: (304) 664-3848 \| Fax: (304) 664-3669
Administrative Mailing Address	PO BOX 456, JUSTICE, WV, 24851-0456
Enumeration & Last Sync	Enumerated: 2014-10-28 \| CMS Record Updated: 2014-10-28
Authorized Official	TYLER BLANKENSHIP (Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

HC 68 BOX 456, HANOVER, WV, 24839-9731

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Plain-English Taxonomy & CMS Crosswalk (341600000X)

What Does Taxonomy Code 341600000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 341600000X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 59 (Ambulance Service Provider)
Certifying / Accrediting Authority: State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Clinical Scope: Emergency 911 pre-hospital medical response or medically supervised inter-hospital critical care transport.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SOUTHERN EMS LLC)

Typical CPT / Diagnostic Procedures:

Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
Pre-Hospital Trauma Immobilization, Airway Management & IV Access

Common Therapeutic Classes:

Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`341600000X` — Ambulance Plain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance	State: WV \| License: `2295-6669` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SOUTHERN EMS LLC (NPI #1417352840)