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Organization

EMERGENCY MEDICAL TRANSPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMY S WESTON (BILLING MANAGER)
(501) 622-0112
Entity
Organization

Contact information

Practice address
115 N 3RD ST, GLENWOOD, AR 71943
(501) 622-0112
(501) 767-0329
Mailing address
PO BOX 766, GLENWOOD, AR 71943-0766
(501) 622-0112
(501) 767-0329

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
878
AR
3416L0300X
Land Ambulance
878
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149161718
AR
Enumeration date
09/12/2005
Last updated
06/17/2008
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