Roger Vines LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

411 Issued in AL

Legal business name

ROGER VINES LLC

Doing business as

Vines Ambulance Service

Practice address

211 B St
Lafayette, AL 36862-2095

Phone

(334) 864-7128

Fax

(334) 864-8184

NPI assigned

Oct 19, 2006

Last updated

Apr 6, 2014By 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

Roger Vines LLC

Title

Owner/Director

Phone

(334) 864-7128

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Vines Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396742400000",
    "number": "1497837421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 B ST",
            "address_2": "P.O. BOX 198",
            "city": "LAFAYETTE",
            "state": "AL",
            "postal_code": "368622095",
            "telephone_number": "334-864-7128",
            "fax_number": "334-864-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 B ST",
            "city": "LAFAYETTE",
            "state": "AL",
            "postal_code": "368622095",
            "telephone_number": "334-864-7128",
            "fax_number": "334-864-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER VINES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-04-06",
        "status": "A",
        "authorized_official_last_name": "VINES     LLC",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "334-864-7128"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AL",
            "license": "411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF ALABAMA",
            "identifier": "051052949",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104579",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vines Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Lafayette, AL
• Providers in Lafayette, AL by specialty
• Land Ambulance in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2014; 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.