Healthcare Provider Details

I. General information

NPI: 1316943566
Provider Name (Legal Business Name): ACADIAN AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E KALISTE SALOOM RD
LAFAYETTE LA
70508-8308
US

IV. Provider business mailing address

PO BOX 92970
LAFAYETTE LA
70509-2970
US

V. Phone/Fax

Practice location:
  • Phone: 800-259-3333
  • Fax: 337-291-4400
Mailing address:
  • Phone: 800-259-3333
  • Fax: 337-291-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number9110002
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number9110003
License Number StateLA

VIII. Authorized Official

Name: THOMAS LEONARDS
Title or Position: MANAGER OF CONTRACTS
Credential:
Phone: 337-291-4039