Healthcare Provider Details

I. General information

NPI: 1710031091
Provider Name (Legal Business Name): D'ARBONNE AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 MARION HWY
FARMERVILLE LA
71241-9313
US

IV. Provider business mailing address

1109 MARION HWY P.O. BOX 311
FARMERVILLE LA
71241-9313
US

V. Phone/Fax

Practice location:
  • Phone: 318-368-7033
  • Fax: 318-368-8603
Mailing address:
  • Phone: 318-368-7033
  • Fax: 318-368-8603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number9110015
License Number StateLA

VIII. Authorized Official

Name: MR. STEPHAN ALAN HYDE
Title or Position: PRESIDENT
Credential:
Phone: 318-368-7033