Healthcare Provider Details

I. General information

NPI: 1962415232
Provider Name (Legal Business Name): WOODRUFF COUNTY AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 NORTH EDMONDS AVE
MCCRORY AR
72101
US

IV. Provider business mailing address

PO BOX 402
MCCRORY AR
72101-0402
US

V. Phone/Fax

Practice location:
  • Phone: 870-731-2072
  • Fax: 870-731-0032
Mailing address:
  • Phone: 870-731-2072
  • Fax: 870-731-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. JUDY CAROL GARNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-731-2072