# FT RUCKER EMS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LYSTER ARMY HEALTH CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467614362
- **Legal business name:** LYSTER ARMY HEALTH CLINIC
- **Authorized official:** MR. DAVID N HATAWAY PARAMEDIC (CHIEF EMS)
- **Authorized official phone:** (334) 255-7032

## Contact information

- **Practice address:** BLDG 301 ANDREWS AVE, FT RUCKER, AL 36362-5333
- **Practice address phone:** (334) 255-7032
- **Mailing address:** BLDG 301 ANDREWS AVE, FT RUCKER, AL 36362-5333
- **Mailing address phone:** (334) 255-7032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 9142973 | AL | Yes |

## Other

- **Enumeration date:** 07/01/2008
- **Last updated:** 07/01/2008