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General NPI Number Information
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NPI Number | 1073858833
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Entity Type | Organization
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Legal Business Name | ARCHERY TRANSPORT LLC
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 625 CEDAR CREEK RD
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City | BUFFALO
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State | TX
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Zip | 75831-7509
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Country | US
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Telephone | 903-724-9058
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Fax | 903-322-4718
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Provider Business Mailing Address
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Address Line | PO BOX 2737
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City | PALESTINE
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State | TX
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Zip | 75802-2737
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Country | US
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Telephone | 903-724-9058
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Fax | 903-322-4718
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | MR. JAMES C REED
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Credential | EMT-I
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Telephone | 903-724-9058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1000870
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License Number State | TX
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