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General NPI Number Information
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NPI Number | 1760832638
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Entity Type | Organization
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Legal Business Name | NORTH MISSISSIPPI GROUND AMBULANCE, LLC
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 1361 S GREEN ST
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City | TUPELO
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State | MS
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Zip | 38804-6304
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Country | US
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Telephone | 662-377-4243
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Fax |
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Provider Business Mailing Address
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Address Line | 830 S GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38801-4934
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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 | CFO
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Name | SHARON NOBLES
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Credential |
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Telephone | 662-377-2670
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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 |
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License Number State |
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