Provider Demographics
NPI:1508038100
Name:NORTHWEST AMBULANCE SERVICE
Entity Type:Organization
Organization Name:NORTHWEST AMBULANCE SERVICE
Other - Org Name:NORTHWEST MEDICAL CENTER AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-487-7000
Mailing Address - Street 1:1530 US HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5056
Mailing Address - Country:US
Mailing Address - Phone:205-487-7000
Mailing Address - Fax:205-487-7645
Practice Address - Street 1:1530 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5056
Practice Address - Country:US
Practice Address - Phone:205-487-7000
Practice Address - Fax:205-487-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8643416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport