Provider Demographics
NPI:1821418922
Name:LIBERTY EMS SERVICE LLC
Entity Type:Organization
Organization Name:LIBERTY EMS SERVICE LLC
Other - Org Name:LIBERTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-243-8037
Mailing Address - Street 1:316 FEATHERSTON ST
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:AR
Mailing Address - Zip Code:72958-8337
Mailing Address - Country:US
Mailing Address - Phone:479-243-8037
Mailing Address - Fax:479-339-8968
Practice Address - Street 1:316 FEATHERSTON ST
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:AR
Practice Address - Zip Code:72958-8337
Practice Address - Country:US
Practice Address - Phone:479-243-8037
Practice Address - Fax:479-339-8968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance