# TOWN OF VIDALIA

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

## Provider details

- **NPI number:** 1083758668
- **Authorized official:** MATT TAUNTON (EMS DIRECTOR)
- **Authorized official phone:** (318) 336-6262

## Contact information

- **Practice address:** 204 VERNON STEVENS BLVD, VIDALIA, LA 71373-5001
- **Practice address phone:** (318) 336-6262
- **Mailing address:** PO BOX 2010, VIDALIA, LA 71373-2010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 9110062 | LA | Yes |

## Other

- **Enumeration date:** 02/16/2007
- **Last updated:** 07/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1697516 | — | LA |
| 01 | — | 590012309 | RAILROAD MEDICARE | LA |
| 01 | — | C8277 | BCBS | LA |