Organization
CITY OF MARION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DOUGLAS BLAKE (CAPTAIN)
(901) 409-2876
Entity
Organization
Contact information
Practice address
364 MILITARY RD, MARION, AR 72364-1734
(870) 739-4127
Mailing address
PO BOX 83, MARION, AR 72364-0083
(807) 739-4127
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
693
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114141715
—
AR
Enumeration date
04/10/2007
Last updated
03/31/2011
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