City of Olive Branch

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF OLIVE BRANCH

Doing business as

Olive Branch Fire Dept. Ambulance

Practice address

9200 Pigeon Roost Rd
Olive Branch, MS 38654-2421

Phone

(662) 892-9236

Fax

(662) 892-9221

NPI assigned

Jan 4, 2006

Organization subpart

No

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

Authorized official

Name

Ken Adams

Title

Mayor

Phone

(662) 892-9236

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Olive Branch Fire Dept. Ambulance Doing business as

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": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1245218742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 PIGEON ROOST RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542421",
            "telephone_number": "662-892-9236",
            "fax_number": "662-892-9221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7745 Craft Rd",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386541039",
            "country_code": "US",
            "telephone_number": "662-892-9236",
            "fax_number": "662-892-9221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7750 Hacks Cross Rd",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386544204",
            "country_code": "US",
            "telephone_number": "662-892-9236",
            "fax_number": "662-892-9221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5765 Pleasant Hill Road",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386549506",
            "country_code": "US",
            "telephone_number": "662-892-9236",
            "fax_number": "662-892-9221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CITY OF OLIVE BRANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "MAYOR",
        "authorized_official_telephone_number": "662-892-9236"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MS",
            "license": "105",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000016581",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4581042",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00050725",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olive Branch Fire Dept. Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Olive Branch Fire Dept. Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Land Ambulance in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.