Organization
WILLIE GOSS AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE GOSS (PRESIDENT)
(662) 289-1523
Entity
Organization
Contact information
Practice address
806 N JACKSON ST, KOSCIUSKO, MS 39090-3130
(662) 289-1523
(662) 289-1597
Mailing address
PO BOX 303, KOSCIUSKO, MS 39090-0303
(662) 289-1523
(662) 289-1597
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
318
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00552958
—
MS
05
—
82698300
—
WI
Enumeration date
05/26/2006
Last updated
08/22/2020
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