Provider Demographics
NPI:1801979273
Name:MCGEHEE FIRE AND AMBULANCE
Entity type:Organization
Organization Name:MCGEHEE FIRE AND AMBULANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF / EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:870-222-3160
Mailing Address - Street 1:901 HOLLY ST
Mailing Address - Street 2:PO BOX 612
Mailing Address - City:MC GEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654-2142
Mailing Address - Country:US
Mailing Address - Phone:870-222-3160
Mailing Address - Fax:870-222-5729
Practice Address - Street 1:901 HOLLY ST
Practice Address - Street 2:
Practice Address - City:MC GEHEE
Practice Address - State:AR
Practice Address - Zip Code:71654-2142
Practice Address - Country:US
Practice Address - Phone:870-222-3160
Practice Address - Fax:870-222-5729
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF MCGEHEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-22
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR477146L00000X
AR04773416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116745715Medicaid
AR116745715Medicaid
AR47096Medicare ID - Type Unspecified