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General NPI Number Information
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NPI Number | 1861422560
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Entity Type | Organization
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Legal Business Name | CRITTENDEN EMS LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 205 S 2ND ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-4307
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Country | US
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Telephone | 870-733-1166
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Fax | 870-733-1168
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Provider Business Mailing Address
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Address Line | PO BOX 50
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City | MARION
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State | AR
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Zip | 72364-0050
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Country | US
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Telephone | 870-733-1166
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Fax | 870-733-1168
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Authorized Official
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Title or Position | OFFICE MANGAER
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Name | GENNY C. HALLUM
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Credential |
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Telephone | 870-733-1166
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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 | 696
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License Number State | AR
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