Healthcare Provider Details

I. General information

NPI: 1780752402
Provider Name (Legal Business Name): LINCOLN EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 MCLAIN AVE
LINCOLN AL
35096-0172
US

IV. Provider business mailing address

PO BOX 172
LINCOLN AL
35096-0172
US

V. Phone/Fax

Practice location:
  • Phone: 205-763-7777
  • Fax:
Mailing address:
  • Phone: 205-763-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number614
License Number StateAL

VIII. Authorized Official

Name: JOEY CALLAHN
Title or Position: DIRECTOR
Credential:
Phone: 205-763-7777