Provider Demographics
NPI:1790761781
Name:ALEXANDER CITY AMB SER
Entity Type:Organization
Organization Name:ALEXANDER CITY AMB SER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:L
Authorized Official - Middle Name:KEM
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CAPTAIN
Authorized Official - Phone:256-329-6761
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35011-0552
Mailing Address - Country:US
Mailing Address - Phone:256-329-6761
Mailing Address - Fax:256-329-6786
Practice Address - Street 1:38 COURT SQ
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-1929
Practice Address - Country:US
Practice Address - Phone:256-329-6761
Practice Address - Fax:256-329-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========Medicare UPIN