Organization
RUSTON LINCOLN AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WELLS (DIRECTOR OF EMS)
(318) 251-8628
Entity
Organization
Contact information
Practice address
920 E GEORGIA AVE, RUSTON, LA 71270-3937
(318) 251-8628
(318) 747-9994
Mailing address
PO BOX 2069, RUSTON, LA 71273-2069
(318) 251-8607
(318) 747-9994
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
9110052
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1122459
—
LA
01
—
13466
BLUE CROSS BLUE SHIELD LA
LA
Enumeration date
10/17/2006
Last updated
03/13/2023
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