Prim Fire & E.M.S., Inc.
Organization Active NPI Land Ambulance · Prim, AR
NPI 1710197223 · NPPES record last updated Aug 11, 2008
Key facts
- NPI
- 1710197223
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 295 (AR)
- Legal business name
- PRIM FIRE & E.M.S., INC.
- Practice address
- 4119 Prim Rd
Prim, AR 72130 - Phone
- (870) 948-2636
- Fax
- (870) 948-2633
- NPI assigned
- May 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Patti R Carlton
- Title
- EMS Director
- Phone
- (870) 948-2636
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080313000658 | AR | Part B Supplier - Ambulance Service Supplier | 1355426362 | Practice locations: Prim, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 295 | AR | Yes |
Addresses
Primary practice location
4119 Prim Rd
Prim, AR 72130
Mailing address
PO Box 105
Prim, AR 72130-0105
Phone (870) 948-2636
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135947715 | Medicaid | AR |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.