Organization
MED EXPRESS AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE KENNEDY (ACCOUNTS RECEIVABLES SPECIALIST)
(373) 623-0056
Entity
Organization
Contact information
Practice address
505 CHURCH ST, MELVILLE, LA 71353
(337) 623-0056
(337) 623-4789
Mailing address
PO BOX 527, MELVILLE, LA 71353-0527
(337) 623-0056
(337) 623-4789
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
9110034
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1951277
—
LA
01
—
52978
BLUECROSS BLUESHIELD #
LA
01
—
590009304
RAILROAD MEDICARE
LA
01
—
N283602
WELLCARE
LA
Enumeration date
07/05/2005
Last updated
06/29/2022
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