Organization
ROGER VINES LLC
Active
Other names
Vines Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER VINES LLC (OWNER/DIRECTOR)
(334) 864-7128
Entity
Organization
Contact information
Practice address
211 B ST, LAFAYETTE, AL 36862-2095
(334) 864-7128
(334) 864-8184
Mailing address
211 B ST, P.O. BOX 198, LAFAYETTE, AL 36862-2095
(334) 864-7128
(334) 864-8184
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
411
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051052949
BC/BS OF ALABAMA
AL
05
—
104579
—
AL
Enumeration date
10/19/2006
Last updated
04/06/2014
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