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Organization
TOWN OF VIDALIA
Active
Organization
TOWN OF VIDALIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT TAUNTON (EMS DIRECTOR)
(318) 336-6262
Entity
Organization
Contact information
Practice address
204 VERNON STEVENS BLVD, VIDALIA, LA 71373-5001
(318) 336-6262
Mailing address
PO BOX 2010, VIDALIA, LA 71373-2010
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
9110062
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697516
—
LA
01
—
590012309
RAILROAD MEDICARE
LA
01
—
C8277
BCBS
LA
Enumeration date
02/16/2007
Last updated
07/23/2012
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