Aaa Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

AAA AMBULANCE SERVICE

Practice address

100 Rawls Springs Loop Rd
Hattiesburg, MS 39402-8491

Phone

(601) 264-2221

Fax

(601) 255-0896

NPI assigned

Aug 15, 2006

Last updated

Oct 3, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lydia Jefcoat, CPA

Title

Chief Financial Officer

Phone

(601) 264-3581

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1003829375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17889",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394047889",
            "telephone_number": "601-264-2221",
            "fax_number": "601-255-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RAWLS SPRINGS LOOP RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028491",
            "telephone_number": "601-264-2221",
            "fax_number": "601-255-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "JEFCOAT",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "601-264-3581",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MS",
            "license": "001-ALS-PARAMEDIC",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00050057",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.