# NORTH MISS AMBULANCE SERVICE INC

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

## Provider details

- **NPI number:** 1396849436
- **Authorized official:** MR. TIMOTHY DORN (CFO)
- **Authorized official phone:** (303) 495-1200

## Contact information

- **Practice address:** 2202 E CHAMBERS DRIVE, BOONEVILLE, MS 38829
- **Practice address phone:** (662) 728-3201
- **Practice address fax:** (662) 728-1403
- **Mailing address:** PO BOX 198408, ATLANTA, GA 30384-8408
- **Mailing address phone:** (330) 762-8891
- **Mailing address fax:** (330) 384-4019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 067 | MS | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 04/05/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00050885 | — | MS |
| 05 | — | 1517593 | — | TN |