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General NPI Number Information
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NPI Number | 1649691494
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Entity Type | Organization
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Legal Business Name | PRECISION AMBULANCE LLC
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 722 N EASTERN AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2062
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Country | US
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Telephone | 765-222-1062
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Fax | 765-222-1190
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Provider Business Mailing Address
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Address Line | PO BOX 424
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City | CONNERSVILLE
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State | IN
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Zip | 47331-0424
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Country | US
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Telephone | 765-222-1062
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Fax | 765-222-1190
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. REBECCA ST CLAIR
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Credential |
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Telephone | 765-222-1062
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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 | 2371
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License Number State | IN
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