Provider Demographics
NPI:1134123540
Name:ALLEN PARISH AMBULANCE SERVICE
Entity Type:Organization
Organization Name:ALLEN PARISH AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAMIAN
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-738-2674
Mailing Address - Street 1:PO BOX 1319
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-1319
Mailing Address - Country:US
Mailing Address - Phone:337-738-2674
Mailing Address - Fax:337-738-3027
Practice Address - Street 1:215 N 9TH ST
Practice Address - Street 2:
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-3632
Practice Address - Country:US
Practice Address - Phone:337-738-2674
Practice Address - Fax:337-738-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9110004341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA36062OtherBLUE CROSS
LA1309591Medicaid
LA1309591Medicaid