Provider Demographics
NPI:1760410278
Name:YELL COUNTY EMS
Entity Type:Organization
Organization Name:YELL COUNTY EMS
Other - Org Name:YELL COUNTY AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:479-495-7831
Mailing Address - Street 1:1007 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72833-8801
Mailing Address - Country:US
Mailing Address - Phone:479-495-7831
Mailing Address - Fax:479-495-7390
Practice Address - Street 1:1007 E 8TH ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AR
Practice Address - Zip Code:72833-8801
Practice Address - Country:US
Practice Address - Phone:479-495-7831
Practice Address - Fax:479-495-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106609715Medicaid
172202900OtherFEDERAL WORKS COMP
590083464OtherPALMETTO