Edward Alcazar-Lopez

Individual provider Active NPI Basic Emergency Medical Technician · Fort Stewart, GA

NPI 1629478102 · NPPES record last updated Sep 3, 2014

Key facts

NPI
1629478102
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(650) 307-4093
NPI assigned
Sep 3, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X Yes

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (650) 307-4093

Other providers in Fort Stewart, GA

All providers in Fort Stewart, GA · Basic Emergency Medical Technician in Georgia

Sources for this page

Verify at the official NPI Registry.