1336583806 NPI number — ACADIAN AMBULANCE SERVICE OF TEXAS LLC

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 1336583806 NPI number — ACADIAN AMBULANCE SERVICE OF TEXAS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADIAN AMBULANCE SERVICE OF TEXAS 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:
Provider Other Organization Name Type Code:
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:
1336583806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 92970
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70509-2970
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3720 CORLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAUMONT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77701-6431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-259-2222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LEONARDS
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER OF CONTRACTS
Authorized Official Telephone Number:
337-291-4039

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1000848 , 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)





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