Provider Demographics
NPI:1578591137
Name:CITY OF ARAB (AMBULANCE SERVICE)
Entity Type:Organization
Organization Name:CITY OF ARAB (AMBULANCE SERVICE)
Other - Org Name:ARAB AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-586-8819
Mailing Address - Street 1:740 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-1020
Mailing Address - Country:US
Mailing Address - Phone:256-586-8819
Mailing Address - Fax:256-931-3993
Practice Address - Street 1:740 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1020
Practice Address - Country:US
Practice Address - Phone:256-586-8819
Practice Address - Fax:256-931-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL200048101Medicaid
AL200048101Medicaid