Healthcare Provider Details

I. General information

NPI: 1487631305
Provider Name (Legal Business Name): FORT SMITH EMERGENCY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S GREENWOOD AVE
FORT SMITH AR
72901-4243
US

IV. Provider business mailing address

1701 S GREENWOOD AVE
FORT SMITH AR
72901-4243
US

V. Phone/Fax

Practice location:
  • Phone: 479-783-1078
  • Fax: 479-783-2913
Mailing address:
  • Phone: 479-783-1078
  • Fax: 479-783-2913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number727
License Number StateAR

VIII. Authorized Official

Name: MR. PAUL OWENSBY
Title or Position: DIRECTOR
Credential:
Phone: 479-783-1078