Provider Demographics
NPI:1407906563
Name:ADVANCED EMERGENCY MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:ADVANCED EMERGENCY MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-382-0380
Mailing Address - Street 1:900 SHREVEPORT RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3832
Mailing Address - Country:US
Mailing Address - Phone:318-382-0380
Mailing Address - Fax:318-382-0383
Practice Address - Street 1:900 SHREVEPORT RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3832
Practice Address - Country:US
Practice Address - Phone:318-382-0380
Practice Address - Fax:318-382-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9110071341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1566691Medicaid
LA1566691Medicaid