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General NPI Number Information
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NPI Number | 1497774327
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Entity Type | Organization
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Legal Business Name | CLAIBORNE AMBULANCE
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 606 E COLLEGE ST
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City | HOMER
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State | LA
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Zip | 71040-3202
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Country | US
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Telephone | 318-927-1141
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Fax | 318-927-2141
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Provider Business Mailing Address
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Address Line | 606 E COLLEGE ST
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City | HOMER
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State | LA
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Zip | 71040-3202
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Country | US
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Telephone | 318-927-1141
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Fax | 318-927-2141
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAY WATSON
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Credential | OWNER
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Telephone | 318-927-1141
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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 | 25864
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License Number State | LA
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