Organization
COUNTY OF HAMILTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA L. HARRIS (ACCOUNTS MANAGER)
(386) 792-6817
Entity
Organization
Contact information
Practice address
207 1ST ST NE, 902 US HWY 41 NW, JASPER, FL 32052-6633
(386) 792-1288
(386) 792-6432
Mailing address
207 1ST ST NE, JASPER, FL 32052-6633
(386) 792-1288
(386) 792-6432
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
002519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088053100
—
FL
Enumeration date
06/18/2006
Last updated
05/10/2012
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