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General NPI Number Information
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NPI Number | 1710197223
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Entity Type | Organization
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Legal Business Name | PRIM FIRE & E.M.S., INC.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 4119 PRIM RD
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City | PRIM
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State | AR
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Zip | 72130
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Country | US
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Telephone | 870-948-2636
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Fax | 870-948-2633
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | PRIM
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State | AR
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Zip | 72130-0105
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Country | US
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Telephone | 870-948-2636
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Fax | 870-948-2633
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MR. PATTI R CARLTON
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Credential |
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Telephone | 870-948-2636
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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 | 295
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License Number State | AR
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