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General NPI Number Information
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NPI Number | 1760764260
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 11545 OLD HIGHWAY 49
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City | GULFPORT
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State | MS
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Zip | 39503-2654
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Country | US
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Telephone | 601-508-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 11545 OLD HIGHWAY 49
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City | GULFPORT
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State | MS
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Zip | 39503-2654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIE CAIN
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Credential |
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Telephone | 601-928-6604
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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 | 757
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 756
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License Number State | MS
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