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General NPI Number Information
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NPI Number | 1215989207
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Entity Type | Organization
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Legal Business Name | WES MCCABE
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 6337 INDUSTRIAL PARK RD
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City | VAN BUREN
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State | AR
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Zip | 72956-8482
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Country | US
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Telephone | 479-471-5750
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Fax | 479-471-0237
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Provider Business Mailing Address
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Address Line | 6337 INDUSTRIAL PARK RD
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City | VAN BUREN
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State | AR
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Zip | 72956-8482
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Country | US
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Telephone | 479-471-5750
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Fax | 479-471-0237
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Authorized Official
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Title or Position | OWNER
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Name | MR. WESLEY CLAYTON MCCABE
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Credential | EMT-PARAMEDIC
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Telephone | 479-471-5750
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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 | 797
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License Number State | AR
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