Healthcare Provider Details

I. General information

NPI: 1922193218
Provider Name (Legal Business Name): FRANKLIN AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 BUNKLEY ROAD SW MAIN STREET
MEADVILLE MS
39653
US

IV. Provider business mailing address

PO BOX 475
MEADVILLE MS
39653
US

V. Phone/Fax

Practice location:
  • Phone: 601-384-2040
  • Fax: 601-384-2040
Mailing address:
  • Phone: 601-384-2040
  • Fax: 601-384-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number036-BASIC LIFE
License Number StateMS

VIII. Authorized Official

Name: MR. HAROLD LEROY WENTWORTH SR.
Title or Position: OWNER
Credential:
Phone: 601-384-2040