Organization
CITY OF LAFAYETTE EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN PHILLIPS (CHIEF)
2
Entity
Organization
Contact information
Practice address
56 2ND AVE SW, LAFAYETTE, AL 36862-1945
2
Mailing address
PO BOX 87, LAFAYETTE, AL 36862-0087
2
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
289
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51054142
BLUECROSS
AL
Enumeration date
09/26/2006
Last updated
08/22/2020
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