Provider Demographics
NPI:1578921656
Name:LAMAR AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:LAMAR AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-712-6200
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:35592-0327
Mailing Address - Country:US
Mailing Address - Phone:205-695-7718
Mailing Address - Fax:205-695-1006
Practice Address - Street 1:154 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:AL
Practice Address - Zip Code:35592-5635
Practice Address - Country:US
Practice Address - Phone:205-695-7718
Practice Address - Fax:205-695-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport