# CRITTENDEN AMBULANCE SERVICE CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043420094
- **Authorized official:** JENNIFER REVELS (MANAGER)
- **Authorized official phone:** (800) 451-8036

## Contact information

- **Practice address:** 510 E JACKSON AVE, WEST MEMPHIS, AR 72301-4336
- **Practice address phone:** (800) 451-8036
- **Practice address fax:** (870) 777-8479
- **Mailing address:** PO BOX 3127, WEST MEMPHIS, AR 72303-3127
- **Mailing address phone:** (800) 451-8036
- **Mailing address fax:** (870) 777-8479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 633 | AR | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 47153 | ARKANSAS BCBS | AR |