Provider Demographics
NPI:1467459552
Name:MED EXPRESS AMBULANCE SERVICE
Entity Type:Organization
Organization Name:MED EXPRESS AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLES SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:373-623-0056
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71353-0527
Mailing Address - Country:US
Mailing Address - Phone:337-623-0056
Mailing Address - Fax:337-623-4789
Practice Address - Street 1:505 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:LA
Practice Address - Zip Code:71353
Practice Address - Country:US
Practice Address - Phone:337-623-0056
Practice Address - Fax:337-623-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA91100343416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA52978OtherBLUECROSS BLUESHIELD #
LA1951277Medicaid
LAN283602OtherWELLCARE
LA590009304OtherRAILROAD MEDICARE
47076Medicare UPIN