Healthcare Provider Details

I. General information

NPI: 1912087578
Provider Name (Legal Business Name): BOSSIER PARISH E M S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 SWAN LAKE RD
BOSSIER CITY LA
71111-6413
US

IV. Provider business mailing address

PO BOX 1002
BENTON LA
71006-1002
US

V. Phone/Fax

Practice location:
  • Phone: 318-741-9201
  • Fax: 318-741-9204
Mailing address:
  • Phone: 318-741-9201
  • Fax: 318-741-9204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number9110009
License Number StateLA

VIII. Authorized Official

Name: MR. DUXIE SCOTT SR.
Title or Position: DIRECTOR OF EMS
Credential:
Phone: 318-741-9201