Healthcare Provider Details

I. General information

NPI: 1548257470
Provider Name (Legal Business Name): ARKANSAS PARAMEDIC TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N 13TH ST
ROGERS AR
72756-2317
US

IV. Provider business mailing address

1901 N 13TH ST P O BOX 696
ROGERS AR
72756-2317
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-3998
  • Fax: 479-631-8409
Mailing address:
  • Phone: 479-621-3998
  • Fax: 479-631-8409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number169
License Number StateAR

VIII. Authorized Official

Name: MS. MARY A WOLF
Title or Position: OWNER
Credential: R N
Phone: 479-621-3998