Healthcare Provider Details

I. General information

NPI: 1336111335
Provider Name (Legal Business Name): EMERSON AMBULANCE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 E NETTLETON AVE
JONESBORO AR
72401-5165
US

IV. Provider business mailing address

1703 E NETTLETON AVE
JONESBORO AR
72401-5165
US

V. Phone/Fax

Practice location:
  • Phone: 870-935-0380
  • Fax: 870-268-8466
Mailing address:
  • Phone: 870-935-0380
  • Fax: 870-268-8466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number643
License Number StateAR

VIII. Authorized Official

Name: MR. TOBY L EMERSON
Title or Position: PRESIDENT
Credential:
Phone: 870-935-0380