Organization
COUNTY OF LOGAN
Active
Parent organization
COUNTY OF LOGAN
Other names
Logan County Emergency Medical Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF LOGAN
Authorized official
MRS. BETTY A. FAIRBANKS (ADMINISTRATOR)
(479) 963-2723
Entity
Organization
Contact information
Practice address
310 E MAIN ST, PARIS, AR 72855-3328
(479) 963-2723
(479) 963-8355
Mailing address
PO BOX 467, PARIS, AR 72855-0467
(479) 963-2723
(479) 963-8355
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
730
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103244715
—
AR
01
—
47218
BLUE CROSS BLUE SHIELD
AR
01
—
590083475
RAILROAD MEDICARE
AR
01
—
864525
FEDERAL BLACK LUNG PROGRA
AR
Enumeration date
05/24/2005
Last updated
04/20/2011
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