=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447340575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARATECH EMS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2006
-----------------------------------------------------
Last Update Date | 08/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 EAST CHURCH ST
-----------------------------------------------------
City | QUITMAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39355-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-776-6996
-----------------------------------------------------
Fax | 601-776-3320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1 111 EAST CHURCH STREET
-----------------------------------------------------
City | QUITMAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39355-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-776-6996
-----------------------------------------------------
Fax | 601-776-3320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. DEWAYNE M CRANE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 601-776-6996
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 033
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------