Provider Demographics
NPI:1851026330
Name:DISASTER RESPONSE EMERGENCY AMBULANCE MEDICAL SERVICES OF CASA
Entity Type:Organization
Organization Name:DISASTER RESPONSE EMERGENCY AMBULANCE MEDICAL SERVICES OF CASA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF BUSINESS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GANN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NRP
Authorized Official - Phone:979-308-1040
Mailing Address - Street 1:1016 CASA MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CASA
Mailing Address - State:AR
Mailing Address - Zip Code:72025-8113
Mailing Address - Country:US
Mailing Address - Phone:479-264-0885
Mailing Address - Fax:
Practice Address - Street 1:1016 CASA MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CASA
Practice Address - State:AR
Practice Address - Zip Code:72025-8113
Practice Address - Country:US
Practice Address - Phone:479-264-0885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No251300000XAgenciesLocal Education Agency (LEA)
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No333300000XSuppliersEmergency Response System Companies
No3416L0300XTransportation ServicesAmbulanceLand Transport
No342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)