Organization
NORTHWEST MEDICAL TRANSFER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAMILLE A WILCOX (OPERATIONS MANAGER)
(479) 750-7214
Entity
Organization
Contact information
Practice address
2319 LADELLE AVE, LOWELL, AR 72745
(479) 750-7214
Mailing address
2319 LADELLE AVE, LOWELL, AR 72745
(479) 750-7214
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0116
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116
AR AMB SVC LICENSE
AR
01
—
X43141
ALL OTHER INS. ID NO.
AR
Enumeration date
10/02/2006
Last updated
08/22/2020
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