Monticello Ambulance Service Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0434 Issued in AR

Legal business name

MONTICELLO AMBULANCE SERVICE INC.

Practice address

325 West Shelton
Monticello, AR 71655

Phone

(870) 367-7384

Fax

(870) 367-8122

NPI assigned

Dec 6, 2006

Organization subpart

No

Name

Ms. Sherry Carson

Title

President

Phone

(870) 367-7384

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 9, 2010.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1104985449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716570643",
            "telephone_number": "870-367-7384",
            "fax_number": "870-367-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WEST SHELTON",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-7384",
            "fax_number": "870-367-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO AMBULANCE SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-367-7384",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "0434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145645715",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "47301",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Biddle Midlick, PT
• Joseph Pruett Miles, DDS
• MMC Rural Health Clinics, PLLC
• Abid Mohiuddin, MD
• Leigh Ann Montgomery
• Monticello Dental Center PLLC
• Monticello Drug Company LLC
• Monticello Drug Company LLC
• Monticello Drug Inc
• Monticello Ess LLC

• All providers in Monticello, AR
• Land Ambulance in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.