Provider Demographics
NPI:1063402501
Name:OPPORTUNITY EMS INC
Entity type:Organization
Organization Name:OPPORTUNITY EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAYWIOOD
Authorized Official - Middle Name:F
Authorized Official - Last Name:NOWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-493-0911
Mailing Address - Street 1:1107 W CUMMING AVE
Mailing Address - Street 2:
Mailing Address - City:OPP
Mailing Address - State:AL
Mailing Address - Zip Code:36467-2717
Mailing Address - Country:US
Mailing Address - Phone:334-493-0911
Mailing Address - Fax:334-493-4042
Practice Address - Street 1:1107 W CUMMING AVE
Practice Address - Street 2:
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-2717
Practice Address - Country:US
Practice Address - Phone:334-493-0911
Practice Address - Fax:334-493-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL509341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-78716OtherBLUE CROSS/BLUE SHIELD