Provider Demographics
NPI:1104032937
Name:MED-CALL AMBULANCE
Entity Type:Organization
Organization Name:MED-CALL AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TINDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-340-0555
Mailing Address - Street 1:1414 B- 7TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-340-0555
Mailing Address - Fax:256-340-0501
Practice Address - Street 1:737 AVALON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2340
Practice Address - Country:US
Practice Address - Phone:256-340-0555
Practice Address - Fax:256-340-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL922341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051558190Medicare ID - Type Unspecified