Healthcare Provider Details

I. General information

NPI: 1093801136
Provider Name (Legal Business Name): ROGERSVILLE EMERGENCY AMBULANCE UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 WHEELER ST
ROGERSVILLE AL
35652
US

IV. Provider business mailing address

36 WHEELER ST
ROGERSVILLE AL
36552
US

V. Phone/Fax

Practice location:
  • Phone: 256-386-5000
  • Fax:
Mailing address:
  • Phone: 256-386-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number357
License Number StateAL

VIII. Authorized Official

Name: MR. MORRIS LENTZ
Title or Position: CHIEF
Credential:
Phone: 256-386-5000