Provider Demographics
NPI:1386822872
Name:YAZOO AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:YAZOO AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLQUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-885-1730
Mailing Address - Street 1:780 E FOURTEENTH ST
Mailing Address - Street 2:
Mailing Address - City:YAZOO CITY
Mailing Address - State:MS
Mailing Address - Zip Code:39194-2712
Mailing Address - Country:US
Mailing Address - Phone:662-746-7444
Mailing Address - Fax:662-746-8862
Practice Address - Street 1:780 E FOURTEENTH ST
Practice Address - Street 2:
Practice Address - City:YAZOO CITY
Practice Address - State:MS
Practice Address - Zip Code:39194-2712
Practice Address - Country:US
Practice Address - Phone:662-746-7444
Practice Address - Fax:662-746-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9893416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport