1245637974 NPI number — CENTRAL AMBULANCE & MEDICAL SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245637974 NPI number — CENTRAL AMBULANCE & MEDICAL SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL AMBULANCE & MEDICAL SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245637974
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 258
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORDYCE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71742-0258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-352-0348
Provider Business Mailing Address Fax Number:
870-352-0347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 N CLIFTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORDYCE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71742-3026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-352-0348
Provider Business Practice Location Address Fax Number:
870-352-0347
Provider Enumeration Date:
11/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
LUSCOMB
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
870-904-0772

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  501 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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