Provider Demographics
NPI:1750323309
Name:ARKANSAS EXCELLENT TRANSPORT INC
Entity Type:Organization
Organization Name:ARKANSAS EXCELLENT TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-886-6400
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:401 EAST MAIN
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476
Mailing Address - Country:US
Mailing Address - Phone:870-886-6400
Mailing Address - Fax:870-886-6401
Practice Address - Street 1:401 EAST MAIN
Practice Address - Street 2:
Practice Address - City:WANUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476
Practice Address - Country:US
Practice Address - Phone:870-886-6400
Practice Address - Fax:870-886-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0625146L00000X
AR6253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR138746715Medicaid
AR47317Medicare PIN