Crittenden EMS LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

696 Issued in AR

Legal business name

CRITTENDEN EMS LLC

Practice address

205 S 2ND St
West Memphis, AR 72301-4307

Phone

(870) 733-1166

Fax

(870) 733-1168

NPI assigned

Jul 5, 2006

Last updated

Jul 2, 2008By 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

Genny C. Hallum

Title

Office Mangaer

Phone

(870) 733-1166

Specialties & licenses 1

Addresses

Other identifiers 1

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.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1861422560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723640050",
            "telephone_number": "870-733-1166",
            "fax_number": "870-733-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S 2ND ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014307",
            "telephone_number": "870-733-1166",
            "fax_number": "870-733-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITTENDEN EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "HALLUM",
        "authorized_official_first_name": "GENNY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OFFICE MANGAER",
        "authorized_official_telephone_number": "870-733-1166"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157360715",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crittenden Ambulance Service Corp
• Crittenden Cares, Inc (Procare)
• Crittenden Cares, Inc (Crittenden Physician Services)
• Crittenden Cares, Inc. (Crittenden Professional Services)
• Crittenden Emergency Group LLC
• Crittenden Hospital Association
• Crittenden Hospital Association (Crittenden Regional Hospital Home Health-West Memphis)
• Crittenden Hospital Association (Mid-South Women's Clinic)
• Crittenden Hospital Association (Mid-South Minor Medical and Primary Care)
• Crittenden Hospital Association (Crittenden Regional Women's Clinic)

• Land Ambulance in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Land Ambulance in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.