Provider Demographics
NPI:1912087578
Name:BOSSIER PARISH E M S
Entity Type:Organization
Organization Name:BOSSIER PARISH E M S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EMS
Authorized Official - Prefix:MR
Authorized Official - First Name:DUXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:318-741-9201
Mailing Address - Street 1:PO BOX 1002
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-1002
Mailing Address - Country:US
Mailing Address - Phone:318-741-9201
Mailing Address - Fax:318-741-9204
Practice Address - Street 1:5275 SWAN LAKE RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-6413
Practice Address - Country:US
Practice Address - Phone:318-741-9201
Practice Address - Fax:318-741-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA91100093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA46002OtherBLUE CROSS BLUE SHIELD LA
LA1917656Medicaid
LA47070Medicare ID - Type UnspecifiedMEDICARE
LA46002OtherBLUE CROSS BLUE SHIELD LA