Healthcare Provider Details

I. General information

NPI: 1467459552
Provider Name (Legal Business Name): MED EXPRESS AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 CHURCH ST
MELVILLE LA
71353
US

IV. Provider business mailing address

PO BOX 527
MELVILLE LA
71353-0527
US

V. Phone/Fax

Practice location:
  • Phone: 337-623-0056
  • Fax: 337-623-4789
Mailing address:
  • Phone: 337-623-0056
  • Fax: 337-623-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number9110034
License Number StateLA

VIII. Authorized Official

Name: MRS. STEPHANIE KENNEDY
Title or Position: ACCOUNTS RECEIVABLES SPECIALIST
Credential:
Phone: 373-623-0056