Provider Demographics
NPI:1689847261
Name:FORT RUCKER EMS
Entity Type:Organization
Organization Name:FORT RUCKER EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARAMEDIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:REDMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-255-7799
Mailing Address - Street 1:BLD 301A ANDREWS AVENUE
Mailing Address - Street 2:
Mailing Address - City:FT. RUCKER
Mailing Address - State:AL
Mailing Address - Zip Code:36362
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BLD 301A ANDREWS AVENUE
Practice Address - Street 2:
Practice Address - City:FT. RUCKER
Practice Address - State:AL
Practice Address - Zip Code:36362
Practice Address - Country:US
Practice Address - Phone:334-255-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86289793416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport