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General NPI Number Information
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NPI Number | 1679774855
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Entity Type | Organization
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Legal Business Name | BUFFALO ISLAND EMS
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 119 NORTH EDMONDS
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City | MONETTE
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State | AR
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Zip | 72447
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Country | US
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Telephone | 870-930-0333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | MONETTE
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State | AR
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Zip | 72447-0073
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Country | US
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Telephone | 870-930-0333
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BOB BLANKENSHIP
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Credential |
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Telephone | 870-486-5641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0646
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License Number State | AR
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