1528265618 NPI number — AMERICARE EMS LLC

Table of content: (NPI 1528265618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528265618 NPI number — AMERICARE EMS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICARE EMS LLC
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:
AMERICARE MEDICAL TRANSPORTATION, LLC
Provider Other Organization Name Type Code:
3
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:
1528265618
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1802
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENA
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71953-1800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-473-0920
Provider Business Mailing Address Fax Number:
832-877-5040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 N. AVE J
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-473-0920
Provider Business Practice Location Address Fax Number:
877-687-7471
Provider Enumeration Date:
07/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARNOLD
Authorized Official First Name:
GLENDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
888-473-0920

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  PENDING , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 189928801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: AMB894 . This is a "BCBS-TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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